Predictive Value and Impact of No-Reflow Phenomenon after Primary PCI

Background: Angiographic no-reflow after primary percutaneous coronary intervention (PCI) in patients with STelevation myocardial infarction (STEMI) may result in unfavorable outcome. Objectives: The aim of the work was to study the outcome of STEMI patients with no-reflow phenomenon. Patients and Methods: A total of 627 STEMI patients who underwent primary PCI within 24 hours of symptoms onset were divided into a normal flow group (thrombolysis in myocardial infarction [TIMI] flow grade 3) and a no-reflow group (TIMI flow grade <-2), based on angiograms performed after PCI. Results: A total of 78 patients (12.4%) developed noreflow phenomenon. The in-hospital major adverse cardiac events (MACE) were significantly higher in the no-reflow group compared to the in the optimal flow group (30.7% vs. 6.1% respectively, p-0.001). The no-reflow group showed a significantly higher rate of six month MACE compared to the optimal flow group (26.5% vs. 11%, p-0.003). The rate of inhospital mortality was 14.1% in the no reflow group compared to 2.9% in the optimal flow group (p-0.023). Conclusion: Angiographic no-reflow predicts adverse outcome in terms of higher mortality and MACE rates.