Clinical Need

Why do we need better options to diagnose and treat microvascular obstruction?

In the recent decades treatment of heart attacks by minimally invasive percutaneous coronary intervention (PCI) has significantly improved the outcomes for patients. Advances in the technology (stents, balloons, catheters) and pharmaceutical treatments have made the procedure safer and more effective. However, successful re-opening of the narrow or blocked coronary arteries does not always restore blood flow to the entire heart muscle.

More than 1/4 of patients return within one year of treatment with ongoing chest pain or heart failure. Recent evidence in literature suggests the root cause is of a microvascular nature, which is often undetected and untreated at the time. Despite many technology advances in epicardial imaging and diagnostic tools, including those with AI claims, the ability to detect and treat MVO remains an unmet need.

ACC Spotlight Series on Microvascular, October 2022; Quesada, Henry

In acute heart attack STEMI patients, the consequence of microvascular blockages, known as MVO, can be devastating. For every 1% increase in MVO, there is an increase in 1 year risk of mortality by 14%, and for HF hospitalization by 8%. As a prognostic indicator of outcomes, MVO is found to be the single most powerful predictor of clinical outcomes.

Data from Matthijs Van Kranenburg et al., JACC Cardiovasc Imaging. 2014 Sep;7(9):930-9

Data from Giampaolo Niccoli et al., Eur Heart J. 2016 Apr 1;37(13):1024-33