Prevention of coronary microvascular obstruction by addressing ischemia reperfusion injury-part a

Most recently, substantial research efforts were directed to the treatment and prevention of coronary microvascular obstruction (CMVO) by targeting various mechanisms involved in its multifactorial pathophysiology. Among other strategies, antiplatelets and vasodilators were tested in order to reduce thrombus burden and coronary vasospasm potentially resulting in enhanced myocardial perfusion. Furthermore, the impact of intensified statin therapy was evaluated in numerous investigations. Although most of these studies failed to convincingly prove beneficial effects regarding CMVO, especially antiplatelets and statins are indispensable cornerstones of post-infarction medical therapy. This chapter discusses the scientific evidence and guideline recommendations for the use of antiplatelets, statins, and vasodilators in patients with myocardial infarction with a particular focus on their efficacy to treat or prevent CMVO.