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Genetic Scale for Predicting the No-Reflow Phenomenon in Myocardial Infarction.

I G Pochinka¹, A A Frolov², K V Kuzmichev³

¹MD, DSc, Associate Professor, Head of the Department of Endocrinology and Internal Medicine; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.

Sovremennye Tekhnologii V Meditsine

|December 22, 2025

Summary

This summary is machine-generated.

This study identified specific single nucleotide polymorphisms (SNPs) associated with the no-reflow phenomenon after percutaneous coronary intervention in ST-segment elevation myocardial infarction patients. A genetic scale using these SNPs can help predict this complication.

Keywords:

myocardial infarction no-reflow phenomenon percutaneous coronary intervention single nucleotide polymorphism

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Area of Science:

Cardiology
Genetics
Interventional Cardiology

Background:

The no-reflow phenomenon is a complication of percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI).
Identifying genetic factors associated with no-reflow can improve patient risk stratification and management.

Purpose of the Study:

To investigate the association between selected single nucleotide polymorphisms (SNPs) and the development of no-reflow during PCI in STEMI patients.
To develop a genetic scale for predicting no-reflow post-PCI.

Main Methods:

A matched case-control study involving 80 STEMI patients (40 with no-reflow, 40 without).
Assessment of multiple SNPs, including those in ADD1, CYP11B2, and MTHFR genes.
No-reflow defined by TIMI flow grade <3 or Myocardial blush grade <2 post-PCI.

Main Results:

SNPs rs4961 (ADD1), rs1799998 (CYP11B2), and rs1801133 (MTHFR) were significantly associated with no-reflow (p<0.05).
A genetic prognostic scale combining these SNPs showed a positive predictive value of 0.91 and an AUC of 0.724.
Each point increase on the scale correlated with a 5.39-fold increased odds of no-reflow development (p=0.04).

Conclusions:

Specific SNPs in ADD1, CYP11B2, and MTHFR genes are linked to the no-reflow phenomenon in STEMI patients undergoing PCI.
The developed genetic scale demonstrates potential for predicting no-reflow, aiding clinical decision-making.