Although coronary atherosclerosis (coronary artery disease) is a main cause of cardiac
complications, including myocardial infarction, unstable and stable angina and sudden cardiac
death, the link between the two is not univocal. Very often, coronary atherosclerosis does not
translate into cardiac complications. Conversely – what we now would like to call, in a new
comprehensive term – “myocardial ischemic syndromes” may recognize causes unrelated to
the easily visible epicardial obstructive lesions. These may be explained by an interplay of
vasoreactivity, inflammation, dissections, metabolic changes and – occasionally – extra-coronary
or iatrogenic causes. Coronary causes may occur both in the large epicardial vessels and in
the coronary microcirculation. Changes in myocardial metabolism may also cause or worsen
myocardial ischemic syndromes. Most important, causes of myocardial ischemic syndromes often
likely act in concert, also explaining the inadequacy of purely mechanical epicardial coronary
interventions in “non-acute” myocardial ischemic syndromes. Recognizing the multiplicity of
causes for myocardial ischemic syndromes paves the way to individualized, patient-tailored
therapeutic approaches, clearly different in different settings.
This expert meeting will offer an update on risk factors, mechanisms, diagnostics and management
of myocardial ischemic syndromes summoning a group of world-class experts with ample space
devoted to discussions and interaction. An important aspect of the meeting will be devoted
to proposing a new nomenclature of “myocardial ischemic syndromes”, overarching current
terminologies, notably still different between European and American cardiological societies.
The meeting is dedicated to a restricted number of cardiology, cardiac surgery and internal
medicine specialists.
Raffaele De Caterina
Chair and Postgraduate School of Cardiology
University of Pisa
Director
University Cardiology Division
Pisa University Hospital
Pisa, Italy