Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?

Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. I...

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Autores principales:	Roberto Scarsini, Dimitrios Terentes-Printzios, Giovanni Luigi De Maria, Flavio Ribichini, Adrian Banning
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2020
Materias:	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/01a373ee1b404c969fd2256a01c6d234
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spelling	oai:doaj.org-article:01a373ee1b404c969fd2256a01c6d2342021-12-04T16:03:03ZWhy, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?10.15420/icr.2019.261756-14851756-1477https://doaj.org/article/01a373ee1b404c969fd2256a01c6d2342020-05-01T00:00:00Zhttps://www.icrjournal.com/articleindex/icr.2019.26https://doaj.org/toc/1756-1477https://doaj.org/toc/1756-1485Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. In this setting, the index of microcirculatory resistance emerged as an accurate tool to identify patients at risk of suboptimal myocardial reperfusion after primary percutaneous coronary intervention who may benefit from novel adjunctive therapies. In the context of non-ST-elevation ACS, coronary physiology should be carefully interpreted and often integrated with intracoronary imaging, especially in cases of ambiguous culprit lesion. Conversely, the functional assessment of bystander coronary disease is favoured by the available evidence, aiming to achieve complete revascularisation. Based on everyday clinical scenarios, the authors illustrate the available evidence and provide recommendations for the functional assessment of infarct-related artery and non-culprit lesions in patients with ACS.Roberto ScarsiniDimitrios Terentes-PrintziosGiovanni Luigi De MariaFlavio RibichiniAdrian BanningRadcliffe Medical MediaarticleSurgeryRD1-811Diseases of the circulatory (Cardiovascular) systemRC666-701ENInterventional Cardiology: Reviews, Research, Resources, Vol 15, Iss , Pp - (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Surgery RD1-811 Diseases of the circulatory (Cardiovascular) system RC666-701 Roberto Scarsini Dimitrios Terentes-Printzios Giovanni Luigi De Maria Flavio Ribichini Adrian Banning Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
description	Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. In this setting, the index of microcirculatory resistance emerged as an accurate tool to identify patients at risk of suboptimal myocardial reperfusion after primary percutaneous coronary intervention who may benefit from novel adjunctive therapies. In the context of non-ST-elevation ACS, coronary physiology should be carefully interpreted and often integrated with intracoronary imaging, especially in cases of ambiguous culprit lesion. Conversely, the functional assessment of bystander coronary disease is favoured by the available evidence, aiming to achieve complete revascularisation. Based on everyday clinical scenarios, the authors illustrate the available evidence and provide recommendations for the functional assessment of infarct-related artery and non-culprit lesions in patients with ACS.
format	article
author	Roberto Scarsini Dimitrios Terentes-Printzios Giovanni Luigi De Maria Flavio Ribichini Adrian Banning
author_facet	Roberto Scarsini Dimitrios Terentes-Printzios Giovanni Luigi De Maria Flavio Ribichini Adrian Banning
author_sort	Roberto Scarsini
title	Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
title_short	Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
title_full	Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
title_fullStr	Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
title_full_unstemmed	Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
title_sort	why, when and how should clinicians use physiology in patients with acute coronary syndromes?
publisher	Radcliffe Medical Media
publishDate	2020
url	https://doaj.org/article/01a373ee1b404c969fd2256a01c6d234
work_keys_str_mv	AT robertoscarsini whywhenandhowshouldcliniciansusephysiologyinpatientswithacutecoronarysyndromes AT dimitriosterentesprintzios whywhenandhowshouldcliniciansusephysiologyinpatientswithacutecoronarysyndromes AT giovanniluigidemaria whywhenandhowshouldcliniciansusephysiologyinpatientswithacutecoronarysyndromes AT flavioribichini whywhenandhowshouldcliniciansusephysiologyinpatientswithacutecoronarysyndromes AT adrianbanning whywhenandhowshouldcliniciansusephysiologyinpatientswithacutecoronarysyndromes
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Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?

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