Spontaneous reperfusion in ST-elevation myocardialinfarction

Authors: Kalinskaya A.I., Uzhakhova Kh.M., Vasilieva E.Yu., Shpektor A.V.

Company: Cardiology Chair, Yevdokimov Moscow State University of Medicine and Dentistry of Ministry of Health of the Russian Federation, ulitsa Delegatskaya, 20/1, Moscow, 127473, Russian Federation

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Type:  Reviews

DOI: https://doi.org/10.24022/1997-3187-2019-13-2-173-183

For citation: Kalinskaya A.I., Uzhakhova Kh.M., Vasilieva E.Yu., Shpektor A.V. Spontaneous reperfusion in ST-elevation myocardial infarction. Creative Cardiology. 2019; 13 (2): 173–183 (in Russ.). DOI: 10.24022/1997-3187-2019- 13-2-173-183

Received / Accepted:  21.05.2019/27.05.2019

Keywords: spontaneous reperfusion endogenous fibrinolysis endothelial dysfunction myocardial infarction

Full text:  



Myocardial infarction currently remains one of the leading causes of death and hospitalization. The most common pathogenetic mechanism for the development of acute myocardial infarction is the formation of a thrombus in the arterial lumen due to atherosclerotic plaque rupture. Whether it is going to be total or partial occlusion of the coronary artery depends on the balance between coagulation, anticoagulation and fibrinolytic systems. In patients with ST-segment elevation myocardial infarction full or partial spontaneous restoration of blood flow of the infarct-related artery may occur without thrombolysis or primary coronary intervention. The spontaneous restoration of blood flow in the infarct-related artery improves both the short-term and long-term prognoses of patients with acute myocardial infarction. The process of spontaneous restoration of blood flow in the infarctrelated artery is associated primary with increased activation of the endogenous fibrinolytic system. We present a review of the literature data on the main mechanisms of spontaneous fibrinolysis, role of hemostatic system, endothelial function, as well as its effect on the long-term prognosis of patients with acute myocardial infarction.


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About Authors

  • Anna I. Kalinskaya, Cand. Med. Sc., Associate Professor, ORCID
  • Khyadi M. Uzhakhova, Postgraduate, ORCID
  • Elena Yu.Vasilieva, Dr. Med. Sc., Professor, ORCID
  • Aleksandr V. Shpektor, Dr. Med. Sc., Professor, Chief of Chair, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery