Interventi terapeutici per l'obiezione microvascolare coronarica dopo infarto miocardico acuto: sviluppi e sfide.

ST-segment elevation myocardial infarction (STEMI) remains a major global cause of mortality and heart failure, even in the era of primary percutaneous coronary intervention (PCI). While timely epicardial reperfusion is routinely achieved, a substantial subset of patients experiences impaired myocardial perfusion due to coronary microvascular obstruction and dysfunction (MVO). MVO is a complex and multifactorial process driven by ischemia-reperfusion injury, endothelial dysfunction, distal embolization, inflammation, and emerging mechanisms such as pericyte-mediated capillary constriction. MVO is associated with larger infarct size, adverse remodeling, and worse long-term outcomes. While a w