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. 2020 Sep 12;9(9):2956.
doi: 10.3390/jcm9092956.

No-Reflow after PPCI-A Predictor of Short-Term Outcomes in STEMI Patients

Larisa Renata Pantea-Roșan  1   2 , Vlad Alin Pantea  3 , Simona Bungau  4 , Delia Mirela Tit  4 , Tapan Behl  5 , Cosmin Mihai Vesa  2   6 , Cristiana Bustea  2   6 , Radu Dumitru Moleriu  7 , Marius Rus  1   2 , Mircea Ioachim Popescu  1   2 , Vladiana Turi  8 , Camelia Cristina Diaconu  9   10
Affiliations

No-Reflow after PPCI-A Predictor of Short-Term Outcomes in STEMI Patients

Larisa Renata Pantea-Roșan et al. J Clin Med. .

Abstract

The no-reflow phenomenon following primary percutaneous coronary intervention (PPCI) in acute ST-elevation myocardial infarction (STEMI) patients is a predictor of unfavorable prognosis. Patients with no-reflow have many complications during admission, and it is considered a marker of short-term mortality. The current research emphasizes the circumstances of the incidence and complications of the no-reflow phenomenon in STEMI patients, including in-hospital mortality. In this case-control study, conducted over two and a half years, there were enrolled 656 patients diagnosed with STEMI and reperfused through PPCI. Several patients (n = 96) developed an interventional type of no-reflow phenomenon. One third of the patients with a no-reflow phenomenon suffered complications during admission, and 14 succumbed. Regarding complications, the majority consisted of arrhythmias (21.68%) and cardiogenic shock (16.67%). The anterior localization of STEMI and the left anterior descending artery (LAD) as a culprit lesion were associated with the highest number of complications during hospitalization. At the same time, the time interval >12 h from the onset of the typical symptoms of myocardial infarction (MI) until revascularization, as well as multiple stents implantations during PPCI, correlated with an increased incidence of short-term complications. The no-reflow phenomenon in patients with STEMI was associated with an unfavorable short-term prognosis.

Keywords: acute myocardial infarction (MI); no-reflow phenomenon (NRP); primary percutaneous coronary intervention (PPCI); thrombolysis in myocardial infarction (TIMI) risk score.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart describing the way of patient selection (STEMI: ST-segment elevation myocardial infarction, PCI: percutaneous coronary intervention).
Figure 2
Figure 2
The prevalence of complications depending on the culprit artery and STEMI for NRP+ group Legend: RCA: right coronary artery (n = 27); LAD: left anterior descending artery (n = 64); STEMI: ST-segment elevation myocardial infarction (anterior STEMI: n = 65 and inferior STEMI: n = 31).
Figure 3
Figure 3
The dependence between the number of complications and the number of dead patients in the NRP+ group.
Figure 4
Figure 4
The association between the number of complications and the number of dead patients in the NRP+ group.
Figure 5
Figure 5
Pathophysiology mechanisms in the no-reflow phenomenon following primary percutaneous coronary intervention in ST-elevation myocardial infarction patients [47].
See this image and copyright information in PMC

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