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Related Experiment Video

Updated: May 13, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

Myocardial 'no-reflow' prevention.

Michael Magro¹, Tirza Springeling, Robert Jan van Geuns

¹Chief Department of Cardiology, Erasmus MC, Thorax center, 's Gravendijkwal 230, Rotterdam, The Netherlands.

Current Vascular Pharmacology

|March 20, 2013

Summary

Preventing myocardial no-reflow after ST-segment elevation myocardial infarction (STEMI) is vital for better outcomes. Strategies focus on preserving microvascular function and timely interventions during primary percutaneous coronary intervention (PPCI).

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Published on: April 17, 2021

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Last Updated: May 13, 2026

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Published on: May 28, 2019

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs

Published on: April 17, 2021

Area of Science:

Cardiology
Interventional Cardiology
Microvascular Medicine

Background:

Myocardial no-reflow occurs in 5-50% of ST-segment elevation myocardial infarction (STEMI) patients despite successful primary percutaneous coronary intervention (PPCI).
No-reflow predicts larger infarct size and increased short- and long-term mortality.
Preventing no-reflow is critical for improving STEMI patient prognosis.

Purpose of the Study:

To review current strategies for preventing myocardial no-reflow during STEMI treatment.
To discuss pharmacological and mechanical interventions aimed at improving microvascular perfusion.
To highlight the importance of early intervention and risk factor management.

Main Methods:

Review of major clinical trials and studies on no-reflow prevention.
Analysis of strategies including glycaemic control, statin use, reduced ischaemic time, and specific PPCI techniques.
Discussion of pharmacological agents and mechanical interventions.

Main Results:

Optimal glycaemic control and statin therapy reduce no-reflow risk in high-risk patients (e.g., diabetics).
Minimizing door-to-balloon times and employing intracoronary GP IIb/IIIa antagonists and aspiration thrombectomy improve myocardial perfusion.
These interventions are associated with better clinical outcomes in major trials.

Conclusions:

Preventing myocardial no-reflow is a key therapeutic goal in STEMI management.
A multi-faceted approach combining risk factor modification and optimized PPCI techniques is essential.
Further research into novel therapeutic options continues to advance no-reflow prevention strategies.