Department of Cardiology, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
The widespread application of coronary reperfusion strategies in order to limit infarct size is based on the open artery hypothesis formulated by Eugene Braunwald in the 1970s1,2. As a result, the in-hospital mortality declined and the one-year clinical outcome after a first ST-elevation myocardial infarction (STEMI) has improved dramatically in recent decades3. Although primary percutaneous coronary intervention (PPCI) creates a complete recanalisation of the occluded epicardial coronary artery in almost all STEMI patients, this does not result in an effective myocardial reperfusion in about 35% of patients4. This condition, known as the slow or no-reflow phenomenon, has been related to ...
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