Related Experiment Video

Updated: Feb 28, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

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

Published on: May 28, 2019

9.7K

Predictors and outcome of no-reflow post primary percutaneous coronary intervention for ST elevation myocardial

Jawad Mazhar1, Mary Mashicharan1, Ahmad Farshid1,2

  • 1The Canberra Hospital, Canberra, Yamba drive, Garran, ACT 2605, Australia.

International Journal of Cardiology. Heart & Vasculature
|June 16, 2017
PubMed

Insights

No-reflow, a complication of primary percutaneous coronary intervention for STEMI, occurred in 25% of patients. This condition predicts increased mortality risk at 12 months.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • No-reflow phenomenon (TIMI flow < 3) complicates primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in 11-41% of cases.
  • It signifies inadequate myocardial tissue perfusion and is linked to adverse clinical outcomes.
  • Predictors and 12-month outcomes of no-reflow require further investigation.

Purpose of the Study:

  • To identify predictors of no-reflow during primary PCI for STEMI.
  • To evaluate the 12-month clinical outcomes for patients experiencing no-reflow.

Main Methods:

  • Analysis of a PCI database from The Canberra Hospital (2008-2012).
  • Inclusion of 781 patients who underwent primary PCI for STEMI.
  • 12-month follow-up via mail, phone, and hospital record review.

Main Results:

  • No-reflow was observed in 189 patients (25%).
  • No-reflow was associated with older age, higher initial TIMI flow < 3, elevated thrombus score (≥ 4), increased glycoprotein IIb/IIIa inhibitor use, and longer symptom-to-balloon times.
  • No-reflow independently predicted mortality (HR 1.95) at 12 months.
  • Independent predictors of no-reflow included age > 60 years, thrombus score ≥ 4, and symptom-to-balloon time > 360 minutes.
  • In 17% of cases, no-reflow occurred post-stent insertion.

Conclusions:

  • No-reflow complicates primary PCI for STEMI in 25% of patients.
  • Predictors include older age, high thrombus burden, and delayed presentation.
  • No-reflow is an independent predictor of increased 12-month mortality risk.
Abstract

Keywords:
No-reflowPrimary percutaneous coronary interventionST elevation myocardial infarctionSlow coronary flow

More Related Videos

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control05:41

Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control

Published on: December 16, 2022

4.6K
A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.8K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.3K
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
567
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
338
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
347