Prevention of coronary microvascular obstruction by addressing the individual susceptibility

Another pathogenetic component of coronary microvascular obstruction (CMVO) is constituted by the individual susceptibility to microvascular dysfunction, probably related to the function, as well as to the structure and the density of the microcirculation. Common and uncommon cardiovascular risk factors can cause a pre-existing transient or permanent microvascular dysfunction, which contributes to the development and prognosis of acute coronary syndrome. Moreover, genetic factors may enhance the individual susceptibility of CMVO, affecting polymorphism of genes responsible of the onset, trigger and/or modulation of coronary microvascular dysfunction, as well as the resistance to the lysis. Finally, ischemic pre-conditioning may determine the individual susceptibility to CMVO, by protecting both the myocardium and the coronary microcirculation. This chapter summarizes the mechanisms, the effects, the prevention, and treatment of the single causes of individual susceptibility to CMVO.