The impact of adverse cardiac remodeling on clinical prognosis in patients after acute ST-elevation myocardial infarction (STEMI) in the current therapeutic era is not well determined. Although STEMI continues to carry a strong risk of death and major cardiovascular events, the recent improvement of practice protocols in primary percutaneous coronary intervention, using intracoronary imaging (optical coherence tomography, intravascular ultrasound) or additional guiding techniques (coronary physiology to assess macro- and microvascular function) to achieve complete revascularization led to a substantial improvement of both short- and long-term outcomes. However, STEMI patients may develop early adverse remodeling as a result of post-PCI complications associated with myocardial hypoperfusion, such as the no-reflow phenomenon, microvascular obstruction, and intramyocardial hemorrhage, which may occur regardless of myocardial infarction size. These conditions can be predicted and even diagnosed by modern biomarker technologies and require to be treated with advanced strategies. Effective in-hospital management of post-PCI complications might be associated with a decrease in mortality, improvement of well-being and prognosis, as well as and reduction of economic burden on the health system after discharge.

The aim of this Special Issue is to provide a detailed summary of the underlying causes, pathogenesis, diagnostic techniques, predictive biomarkers, and current therapeutic approaches of myocardial hypoperfusion following percutaneous intervention in early adverse cardiac remodeling and worsening clinical outcomes in ST-elevation myocardial infarction. We welcome original studies and review articles on this topic.

Potential topics include but are not limited to the following:

• Concept of adverse cardiac remodeling
• Myocardial hypoperfusion following percutaneous intervention
• Microvascular obstruction and inflammation
• No-reflow phenomenon
• Intramyocardial hemorrhage
• Emerging diagnostic and therapeutic interventions
• New and old biomarkers
• Imaging in ST-elevation myocardial infarction
• Cardioprotection
• Development of predictive models
• Intensive care therapy