The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

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Amending a dogma

EuroIntervention 2018;14:e1258-e1261. DOI: 10.4244/EIJV14I12A227

1. Department of Cardiac Surgery (Emeritus), Medical University of Vienna, Vienna, Austria; 2. Department of Cardiology, Clinical Center of Serbia, Belgrade, Serbia; 3. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA


The dogma “time is muscle”, with a timely reperfusion of acutely occluded coronary arteries, has salvaged myocardium, reduced mortality and prevented crippling consequences in patients with acute coronary syndromes (ACS)1. Very early on, the adverse effects of a sudden uncontrolled reperfusion with an increase in oxygen, pressure and temperature of reflowing blood into previously ischaemic areas were recognised2, later being characterised as ischaemia-reperfusion injury3. Recently, in this journal, the existence of incomplete recovery, underlying pathophysiology of reperfusion and clinical consequences of microcirculatory obstruction was elegantly debated4. Importantly, after myocardial infarction, regional myocardial dysfunction is in part due to a ...

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