Predictive Factors and Impact of No Reflow After Primary Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction

Background— The investigation of no-reflow phenomenon after percutaneous coronary intervention (PCI) in patients with acute ST-segment–elevation myocardial infarction has therapeutic implications. We investigated the predictive factors, persistence in time, and impact of no reflow on myocardial salvage, ventricular function, and mortality. Methods and Results— The study included 1140 patients with ST-segment–elevation myocardial infarction undergoing primary PCI and paired scintigraphic examinations (before intervention and 7 to 14 days thereafter). After primary PCI, 108 patients had no reflow and 1032 patients had normal coronary flow. The median salvage index was 0.34 (interquartile range, 0.15, 0.49) in patients with no reflow versus 0.55 (interquartile range, 0.29, 0.81) in patients with normal flow (P<0.001). Left ventricular ejection fraction at 6 months after PCI was 47.7�13.1% in the no-reflow group versus 54.2�13.9% in the group with normal flow after PCI (P<0.001). In 80.3% of patients with no ...