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Predictive Value of the Endothelial Activation and Stress Index for No-Reflow in NSTEMI Patients Undergoing

Muhammet Cihat Çelik1, Macit Kalçık2, Abdullah Sarıhan1

  • 1Department of Cardiology, Hitit University Erol Olçok Education and Research Hospital, Corum, Turkey.

Cardiovascular Journal of Africa
|May 4, 2026
PubMed

Insights

The Endothelial Activation and Stress Index (EASIX) can predict inadequate myocardial perfusion after PCI in NSTEMI patients. Higher EASIX levels indicate a higher risk of no-reflow, aiding early patient identification.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomarkers

Background:

  • No-reflow phenomenon is a significant complication post-PCI in NSTEMI patients.
  • Endothelial dysfunction and microvascular injury are primary contributors to no-reflow.
  • The Endothelial Activation and Stress Index (EASIX) may serve as a predictor of no-reflow.

Purpose of the Study:

  • To evaluate the predictive value of EASIX for no-reflow in NSTEMI patients undergoing PCI.
  • To identify independent predictors of no-reflow in this patient cohort.

Main Methods:

  • Retrospective study of 543 NSTEMI patients undergoing PCI.
  • Patients categorized into no-reflow (TIMI ≤ 2) and normal reflow (TIMI 3) groups.
  • Logistic regression and ROC analysis used to identify predictors and assess accuracy.

Main Results:

  • No-reflow observed in 13.3% of patients.
  • Higher EASIX, glucose, creatinine, LDH, hs-CRP, and lower LVEF were associated with no-reflow.
  • Elevated EASIX (OR 2.155), reduced LVEF (OR 0.900), and LAD involvement (OR 1.854) independently predicted no-reflow.

Conclusions:

  • Elevated EASIX, reduced LVEF, and LAD culprit lesion are independent predictors of no-reflow post-PCI in NSTEMI.
  • EASIX offers a simple, cost-effective tool for early risk stratification of microvascular obstruction.
Abstract

Keywords:
Endothelial Activation and Stress Index (EASIX)Microvascular dysfunctionNon‐ST‐segment elevation myocardial infarctionNo‐reflowPercutaneous coronary intervention

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