Myocardial Infarction and the Open-Artery Hypothesis

Abstract
In patients with acute myocardial infarction, the prompt restoration of antegrade flow in the infarct-related coronary artery, whether accomplished pharmacologically1 or mechanically,2 improves left ventricular systolic function and reduces mortality. Initially, these salutary effects of reperfusion therapy were thought to be tightly linked: successful reperfusion salvaged ischemic but still viable myocardium, which led to improved left ventricular function and, in turn, improved survival. Conversely, reperfusion of the infarct-related artery more than 12 hours after the onset of infarction was thought not to achieve these beneficial results. However, several studies suggested that the effects of reperfusion on left ventricular function and . . .

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