Association of endothelial dysfunction and no-reflow during primary percutaneous coronary intervention for ST-elevation myocardial infarction.

Abstract Background Coronary no-reflow during primary percutaneous coronary intervention (PPCI) is a predictor of poorer cardiovascular outcome. Both endothelial dysfunction and no-reflow involves abnormal vascular function and hemostasis. Our aim was to assess the association between endothelial dysfunction and no reflow during primary PCI. Methods Thirty consecutive patients with ST elevation myocardial infarction (STEMI) and normal flow during primary PCI were compared to 19 consecutive patients who had no reflow. All subjects underwent assessment of peripheral endothelial function by reactive hyperemia index (RHI) 48–72 h post PCI using the EndoPAT device. Results Age, sex and hypertension were similar in both groups. Smokers were less likely to have no-reflow. Post PPCI there was less ST segment resolution in the no-reflow group (48% ± 7 vs. 81% ± 6; p = 0.001). Patients who had no reflow had subsequently lower ejection fraction (39% ± 10 vs. 47% ± 10; p = 0.015). There was no difference in vascular function (RHI), between the no-reflow and normal flow groups (1.91 ± 0.3 vs. 2.09 ± 0.11; p = 0.24). Conclusions Systemic peripheral endothelial function does not differ between STEMI patients with and without no reflow during primary PCI.