Background: Despite the recent progress in percutaneous coronary intervention (PCI), however, a proportion of patients develop epicardial coronary artery reperfusion but not myocardial reperfusion after primary percutaneous coronary intervention (PPCI), known as no-reflow (NR).
Aim of the Study: This study is conducted to identify simple clinical factors, laboratory, angiographic findings and procedural features that predict no-reflow phenomenon (NR) in patients with STEMI who undergo PCI.
Patients and Methods: We investigated a total of 444 patients who underwent PCI for acute STEMI in Mansoura cardiology department between January 2015 to April 2020 as retrospective and prospective comparative cross-sectional study.
Results: Longer total ischemic time, pathologic Q waves, absence of ST-segment resolution≥50, higher CKMB, higher platelet distribution width(PDW), higher CHA2DS2-VASC risk score, lower EF %, low initial TIMI flow grade, lower myocardial blush grade, high thrombus grade, higher SYNTAX score, higher culprit lesion length, large vessel diameter, complex occlusion, increased number of infarct related artery stents, higher maximal inflation pressure of stent, pre-balloon dilatation and post-balloon dilatation and higher contrast volume were found as significant predictors for the development of NR. The previous independent risk factors can correctly predict NR by 88.2%
Conclusion: The NR predictors in this study might be useful in targeting patients who could benefit from aggressive pharmaco-invasive therapy. Prevention of NR is always better than treatment as development of NR is associated with high morbidity and mortality rates.