title: Intracoronary pharmacotherapy in the management of coronary microvascular dysfunction.
abstract: Although percutaneous coronary intervention restores optimal epicardial blood flow in most cases, abnormal myocardial perfusion may still persist. This might be as a result of macro and microembolization, neutrophil plugging, vasoconstriction, myocyte contracture, local intracellular and interstitial edema, intramural haemorrhage, and endothelial blistering. Local delivery of intracoronary pharmacotherapy via the coronary arteries may increase local drug concentration several fold, and may improve drug efficacy. Several pharmacological agents such as adenosine, calcium channel blockers, alpha blockers, beta2 receptor activators, vasodilators, antithrombotics, and antiplatelet agents have been used to treat coronary microvascular dysfunction. This article reviews the results of trials of intracoronary pharmacotherapy to date.
authors.affiliation: PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 350 Longwood Avenue, First Floor, Boston, MA 02115, USA.
authors.forename: Vijayalakshmi
authors.initials: V
authors.lastname: Kunadian
authors.forename: Cafer
authors.initials: C
authors.lastname: Zorkun
authors.forename: Scott P
authors.initials: SP
authors.lastname: Williams
authors.forename: Leah H
authors.initials: LH
authors.lastname: Biller
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Palmer
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Ogando
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Lew
authors.forename: Navin
authors.initials: N
authors.lastname: Nethala
authors.forename: William J
authors.initials: WJ
authors.lastname: Gibson
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Marble
authors.forename: Jacqueline L
authors.initials: JL
authors.lastname: Buros
authors.forename: C Michael
authors.initials: CM
authors.lastname: Gibson
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003326:Coronary Circulation; D006801:Humans; D007261:Infusions, Intra-Arterial; D055806:Microvessels / Q000503:physiopathology; D015425:Myocardial Reperfusion; D054318:No-Reflow Phenomenon / Q000188:drug therapy*