Predictors Of No-reflow Phenomenon Research Articles

Predictors in no-reflow phenomenon in acute myocardial infarction with ST-segment elevation.

No-reflow (NR) phenomenon is one of the most feared complications after percutaneous coronary intervention (PCI) in the treatment of ST-segment elevation myocardial infarction (STEMI) due to its high morbidity and mortality. To describe the predictive factors for NR phenomenon in a group of subjects with STEMI treated with PCI. One hundred and three cases of STEMI who underwent PCI. The subjects were divided according to the presence of NR phenomenon. In a multivariate analysis age, gender, comorbidities, weight, and other clinical and laboratory parameters were studied as predictors of NR phenomenon were studied. In this study, logistic regression analysis identified as independent factors for the development of NR phenomenon baseline TIMI flow ≤ 2 (OR 6.03; 95% CI, 0.9 to 11.8; p = 0.04), ER KDIGO ≥ 3 (OR OR 2.61; 95% CI, 1.0 to 2.4; p = 0.04). NR phenomenon continues to be a challenge for short and long-term morbidity and mortality in STEMI. The identified factors can be used for the stratification of cases with STEMI and risk of NR phenomenon prior to PCI.

Mean platelet volume-to-lymphocyte ratio as a predictor of no-reflow phenomenon and in-hospital mortality following primary percutaneous coronary intervention in patients with STEMI

Abstract Background ST-segment elevation myocardial infarction (STEMI) is the most severe form of acute coronary syndrome. Primary percutaneous coronary intervention (PCI) is currently the treatment of choice for STEMI. However, many factors can influence the outcomes of primary PCI. Inflammation and platelet activation play a vital role in the development of complications following primary PCI. Recently, the mean platelet volume-to-lymphocyte ratio (MPVLR) has emerged as a novel biomarker of worse outcomes linking inflammation and thrombosis. Purpose The aim of this study was to conduct a systematic review and meta-analysis to investigate the prognostic value of MPVLR as a predictor of no-reflow phenomenon and in-hospital mortality following primary PCI in patients with STEMI. Methods A systematic literature search was performed in the databases of PubMed, ScienceDirect, ProQuest, and Google Scholar. The primary outcomes were no-reflow phenomenon and in-hospital mortality following primary PCI for STEMI. The outcomes were compared between patients with high and low MPVLR at admission. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The Review Manager 5.3 was used to perform the meta-analysis. Results Four cohort studies involving 3038 patients with STEMI undergoing primary PCI were included in this meta-analysis. The pooled analysis showed that a high MPVLR at admission was associated with higher no-reflow phenomenon (odds ratio [OR] = 4.54, 95% confidence interval [CI]: 2.45–8.41, P<0.ehab724.13681, I2=86%) and higher in-hospital mortality (OR=2.69, 95% CI: 1.96–3.68, P<0.ehab724.13681, I2=0%) following primary PCI. Conclusions This systematic review and meta-analysis showed that a high MPVLR predicts no-reflow phenomenon and in-hospital mortality following primary PCI in patients with STEMI. Funding Acknowledgement Type of funding sources: None. MPVLR and no-reflow phenomenonMPVLR and in-hospital mortality

The biomarker macrophage migration inhibitory factor as a predictor of no-reflow phenomenon and other adverse events in patients with ST-segment elevation myocardial infarction

Abstract Major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) may be caused by the “no-reflow” phenomenon. Biomarkers for the “no-reflow” phenomenon prediction is being actively studied. Proinflammatory cytokine macrophage migration inhibitory factor (MIF) is one of the promising biomarkers. Purpose To estimate the role of MIF in the prediction of early reperfusion myocardial injury and MACE in patients with STEMI. Methods The study involved 341 STEMI patients (78.6% male and 21.4% female) with an average age of 59.08±9.65 years. Control group of 12 healthy volunteers included. All patients were made to undergo a baseline investigation. In addition, the level of MIF and soluble suppression of tumorigenicity-2 (sST2) determined twice during the first 12 hours of STEMI, before the PCI and 24 hours after the procedure. Coronary blood flow evaluated using TIMI flow grade and myocardial blush grade (MBG). All patients had epicardial blood flow TIMI 3. The criteria for “no-reflow” diagnosis were myocardial perfusion at MBG 0 or MBG 1 level with complete recovery of epicardial blood flow or ST-segment resolution (rST) of less than 70% from baseline within 2 hours after PCI. All patients were divided into two groups according to MBG and rST after PCI more and less than 70%: 147 patients in the first group with MBG stage 0–1, 182 patients with MBG stage 2–3. Results The level of MIF biomarker determined before PCI was significantly higher in the group of patients with MBG 0–1 in comparison to MBG 2–3. (4386,750±676 pg/ml vs 2935±350 pg/ml; p=0,05). Also, the level of sST2, left ventricular mass index and blood glucose were significantly higher in the group of MBG 0–1 (p=0.03, p=0.006 and p=0.0085, respectively). The difference in left ventricle posterior wall thickness and early to late diastolic transmitral flow velocity (p=0.045) was found between two groups. In the group of MBG 0–1 and rST<70% these parameters were significantly lower (p=0,04 and p=0,05, respectively). Using the multivariate regression analysis, the dependency of the biomarker MIF on the parameters of the reperfusion myocardial injuries were obtained. MIF measured before revascularization was an independent predictor of MBG 0–1 and rST less than 70% (coefficients Beta 0,00057; odd ratio 1,0; 95%confidential interval (CI) 1,0–1,001; p=0,038). The Kaplan-Meier survival analysis showed that long-term adverse outcomes rate after STEMI was significantly higher in patient with the level of MIF determined during the first 12 hours after the event more than 2988 pg/ml (Log-rank = −4,891, p=0.014). Conclusions Biomarkers MIF has a capacity as predictive tool for MACE and “no-reflow” phenomenon in STEMI patients. Funding Acknowledgement Type of funding sources: None.

Red cell distribution width to platelet ratio as a predictor of no-reflow phenomenon in patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Red cell distribution width to platelet ratio as a predictor of no-reflow phenomenon in patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Frequency and predictors of no-reflow phenomenon in patients with COVID-19 presenting with ST-segment elevation myocardial infarction

Objectives Thrombotic process is triggered in the course of Coronavirus disease-2019 (COVID-19), which is a global pandemic, and both arterial and venous systems are affected. ST-elevation myocardial infarction (STEMI) that may develop in these patients may cause more complicated results with the effect of thrombosis burden. Our aim in this study is to determine the frequency of no-reflow phenomenon in COVID-19 patients with STEMI and to determine the factors that predict this complication. Methods In this study, which is a single-centre, retrospective and observational, a total of 126 patients who underwent primary percutaneous coronary intervention (pPCI) in our centre due to STEMI between 11 March 2020 and 10 January 2021 were evaluated. Patients were divided into two groups according to the presence of COVID-19 infection. Results While 62 patients were in the COVID-19 (+) group, 64 patients were evaluated in the COVID-19 (-) group. When the two groups are compared, C-reactive protein, D-dimer, ferritin and neutrophil-lymphocyte ratio (NLR) were significantly higher, and the lymphocyte count was significantly lower in the COVID-19 (+) group. No-reflow was numerically higher in patients with COVID-19. In multivariable analysis, D-dimer and NLR were found to be independent predictors of no-reflow phenomenon in COVID-19 patients. Conclusions Although the no-reflow phenomenon was numerically higher in COVID-19 patients who underwent pPCI due to STEMI compared to the non-COVID group, no statistical difference was found in our study. However, NLR and D-dimer have been identified as independent predictors of no-reflow development risk in COVID-19 patients.

Predictors of no-reflow phenomenon following percutaneous coronary intervention for ST-segment elevation myocardial infarction

ObjectivesNo reflow during percutaneous coronary intervention (PCI) is a complex issue with serious outcomes. Multiple studies have studied predictors of no-reflow during primary PCI, but data on patients with the late presentation is sparse, which constitutes the majority of patients in peripheral centers. This study aimed to determine predictors of no-reflow during PCI in patients with ST-segment elevation myocardial infarction (STEMI) in 7 days. MethodsIt was a single-center prospective case-control study performed at a tertiary care center and included 958 patients with STEMI who underwent PCI within 7 days of symptom onset. Baseline and angiographic data of patients undergoing PCI were recorded and patients divided into reflow and no-reflow group. ResultsOf 958 who underwent PCI, 182 (18.9%) showed no-reflow by myocardial blush grade (MBG)<2. No-reflow group had a higher mean age (66.46±10.71 vs. 61.36±9.94 years), lower systolic blood pressure (SBP) on admission (100.61±26.66 vs. 112.23±24.35, P<0.0001), a higher level of peak Troponin I level (9.37±2.81 vs. 7.66±3.11ng/dL, P<0.0001), low left ventricular ejection fraction (36.71±3.89 vs. 39.58±4.28% respectively P<0.0001). Among angiographic data and procedural features, multivariable logistic regression analysis identified that advanced age, reperfusion time>6hours, SBP<100mmHg on admission, functional status of Killip class for heart failure≥3, lower EF (≤35%), low initial myocardial blush grade (≤1) before PCI, long target lesion length, larger reference diameter of vessel (>3.5mm) and high thrombus burden on angiography were found to be independent predictors of no-reflow (P<0.05). ConclusionNo-reflow phenomenon after PCI for STEMI is complex and multifactorial and can be identified by simple clinical, angiographic, and procedural features. Preprocedural characters of the lesion and early perfusion decides the fate of the outcome.

Novel predictors and adverse long-term outcomes of No-reflow phenomenon in patients with acute ST elevation myocardial infarction undergoing primary percutaneous coronary intervention

ObjectivesThe no-reflow phenomenon occurs in 25% of patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), and may be associated with adverse outcomes. The aim of our study was to detect novel predictors of no-reflow phenomenon and the resulting adverse long term outcomes. MethodsWe enrolled 400 STEMI patients undergoing primary PCI; 228 patients had TIMI flow 3 after PCI (57%) and the remaining 172 patients had TIMI flow <3 (43%). Fibrinogen to albumin ratio (FAR), high sensitive C-reactive protein to albumin ratio (CAR), and atherogenic index of plasma (AIP) were calculated. Long term mortality and morbidity during 6 months follow up were recorded. These data were compared among both groups. ResultsIn multivariate regression analysis, old age (OR = 1.115, 95% CI: 1.032–1.205, P = 0.006), higher troponin level >5.6 ng/mL (OR = 1.040, 95% CI: 1.001–1.080, P = 0.04), diabetes mellitus (OR = 4.401, 95% CI: 1.081–17.923, P = 0.04) and heavy thrombus burden (OR = 16.915, 95% CI: 5.055–56.602, P < 0.001) could be considered as predictors for the development of no-reflow. Interestingly, CAR >0.21, FAR >11.56, and AIP >0.52 could be considered as novel powerful independent predictors (OR = 3.357, 95% CI: 2.288–4.927, P < 0.001, OR = 4.187, 95% CI: 2.761–6.349, P < 0.001, OR = 16.794, 95% CI: 1.018–277.01, P = 0.04, respectively). Higher long term mortality (P < 0.001) and heart failure (P < 0.001) was also strongly related to incidence of no-reflow. ConclusionNo-reflow could be attributed to novel predictors as CAR, FAR, and AIP. This phenomenon was associated with long term adverse events as higher mortality and pump failure.

CHA2DS2-VASc score as a predictor of no-reflow phenomenon after saphenous vein graft percutaneous coronary intervention in patients with non-ST-segment elevation acute coronary syndromes.

Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVGs) is associated with an increased risk of complications, particularly no‑reflow phenomenon and distal embolization due to low patency rates. The CHA2DS2‑VASc score is a clinical risk stratification tool used to predict thromboembolism events especially in patients with nonvalvular atrial fibrillation. The aim of this study was to investigate the relationship between the CHA2DS2‑VASc score and no‑reflow phenomenon after SVG PCI in patients with non-ST‑segment elevation acute coronary syndromes (NSTE‑ACS). In this study, we included 268 patients diagnosed with NSTE‑ACS who underwent PCI for SVG disease in our tertiary cardiovascular center. Patients were divided into 2 groups: group 1 without no‑‑reflow phenomenon (n = 190) and group 2 with no‑reflow phenomenon (n = 78) following the intervention, and then compared based on CHA2DS2‑VASc scores. The CHA2DS2‑VASc score (P <0.001) was significantly higher in group 2, even though no significant difference regarding atrial fibrillation was observed between the study groups. The CHA2DS2‑VASc score (P <0.001), degenerated saphenous vein graft (P = 0.006), and intraluminal thrombus (P <0.001) were found to be independent predictors of no‑reflow phenomenon. Receiver operating characteristics analysis showed that a CHA2DS2‑VASc score of 4 predicted no‑reflow phenomenon with 67.9% sensitivity and 69.3% specificity. Our findings suggest that the CHA2DS2‑VASc score can be an independent predictor of no‑reflow phenomenon in patients undergoing SVG interventions. As a simple and easy‑to‑calculate score, it might be a useful assessment tool to predict no‑reflow phenomenon before SVG interventions in patients with NSTE‑ACS.

Predictors of No-Reflow Phenomenon in ST-Elevation Myocardial Infarction in Patients undergoing Primary Percutaneous Coronary Intervention

Abstract Background Functional single ventricle (FSV) is a spectrum of severe congenital heart disease, with multiple anatomic variations but similar surgical treatment strategies. FSV patients are living longer into adulthood compared to two or three decades ago, and they are more frequently undergoing imaging to assist in clinical and surgical management. Objective To assess the relation between admission eGFR, HDL, Monocytes, CRP &amp; albumin levels in patients presenting with acute STEMI and angiographic no-reflow after primary PCI. Material and Methods From October 2018 to February 2019, 60 patients with STEMI who underwent primary PCI in Ain-Shams University hospitals. All patients subjected to history, clinical examination, ECG pre and post pPCI, pre-pPCI eGFR, monocytes, HDL, CRP and albumin, echocardiography. Patients were divided into two groups based on post-pPCI Thrombolysis in Myocardial Infarction (TIMI) flow grade. No reflow was defined as TIMI flow grades ≤ 2, and normal reflow was defined as TIMI 3 flow grade. All the laboratory parameters were measured on admission before pPCI. Results The study population was divided into 2 groups: reflow (n = 31) and no-reflow (NR) (n = 29) groups. CRP over albumin ration “CAR” (7.9 [4.41-16.18] vs 1.74 [1.54-2.35] (P &amp;lt;.001) were significantly higher in the NR group than in the reflow group, and these factors were found to be independent predictors of NR development. However, eGFR and Monocytes over HDL ratio “MHR” didn’t show any statistical differences between the two groups. Conclusion No-reflow can be predicted by systemic inflammation markers including monocytes, CRP, albumin and HDL. CAR has the highest positive predictive value for no-reflow.

P959The specific characteristics and independent predictors of no-reflow phenomenon, development of a clinically-adaptable risk estimation system

Abstract Introduction No-reflow (NR) phenomenon occurs, when myocardial perfusion is not re-established despite opening the coronary artery during percutaneous coronary intervention (PCI). Purpose Our aim was to identify no-reflow specific characteristics, its independent predictors, and to develop a clinically-adaptable risk score. Methods We have analysed 4085 patient data from two Hungarian cardiovascular centres. We included all STEMI/NSTEMI patients underwent PCI (n=3187). 158 patients treated with papaverine/adenosine formed NR group, while 3029 patients were in control (C) group. Anamnestic parameters, laboratory and operation data were compared. Statistical analysis was carried out with Mann-Whitney-, Fisher test, binary logistic regression and Kaplan Meier survival curve. Based on our results, we designed a risk estimation system, checking its applicability with ROC analysis. Results As for NR-specific characteristics, malignant ventricular arrhythmias (11% vs. 4%, p=0,0031; NR-C consequently) and complications (21% vs. 11%, p=0,064) showed their vulnerability. The increment of glucose (8,1 vs. 7,1 mmol/l, p=0,004), WBC (12,08 vs. 10,5 G/l, p=0,001), CRP (12,46 vs. 7,67 mg/l, p=0,051) and LDL levels (3,34 vs. 3,13 mmol/l, p=0,059) supported the pathomechanism of NR. Higher biomarker levels (troponinT: 2040 vs. 510,5 ng/ml; CK-MB: 100,4 vs. 63,65 U/l, p&lt;0,0001) indicated severe perfusion disturbance. Tendency was seen in higher BMI (28,65 vs. 28,03 kg/m2, p=0,12). STEMI dominated in NR (83 vs. 59%, p&lt;0,0001). Lower platelet level (213,3 vs. 228 G/l, p=0,107) and single vessel disease (46 vs. 25%, p=0,0042) characterized NR. 30-day survival was significantly different (85,1 vs. 93,54%, p&lt;0,0001). The mortality rate of NR in STEMI was 69,7% (69,7% vs. 7,94%, p&lt;0,0001) and in NSTEMI 3,7% (3,7% vs. 4,32%). From the significant differences, CRP was the independent predictor of NR (OR: 1,011, p=0,004; pro 1 mg/l change). Examining STEMI/NSTEMI separately, in STEMI CRP was the independent predictor (OR: 1,0092, p=0,036). In NSTEMI LDL (OR: 4,23, p=0,021) was the independent factor. In the risk score, the following 8 parameters were included: BMI&gt;28 kg/m2, glucose&gt;8 mmol/l, WBC&gt;12 G/l, CK-MB&gt;100 U/l, hs troponin T&gt;2000 ng/ml, CRP&gt;12 mg/l, LDL&gt;3,3 mmol/l, STEMI (yes/no), thus maximum 8 points could be reached. Low (0–1 points, 5–20%), moderate (2–5 points, 55–70%) and high risk groups (6–8 points, 41–11%) were formed. Supervising the model with ROC analysis: AUC=0,69, p=0,0026, which indicates its ability to discriminate effectively between different risk levels of NR. Conclusions The specific characteristics of NR group were identified, from which CRP was the independent predictor - as well as in STEMI, while in NR-NSTEMI LDL was the independent factor. With the elaborated risk estimation system –using anamnestic and routine laboratory parameters– NR could be predicted and unsuccessful PCI could be reduced, resulting in positive therapeutic consequences.

Predictors of No-Reflow Phenomenon: Diabetes Mellitus type II and Obesity and their Associated Mortality in Stemi Patients after Primary PCI

Abstract The prognosis of STEMI patients experiencing the no-reflow phenomenon is unfavorable both in the short- and long-term compared to patients who do not develop this pathology, and it is even worse as other cardiovascular risk factors There is a correlation between the no-reflow phenomenon and diabetes mellitus type II and obesity and this conditions represent stong predictors of mortality.

100.31 Predictors of No-Reflow Phenomenon in Tunisian Patients Undergoing Primary Percutaneous Coronary Intervention for St-Elevation Myocardial Infarction

In patients managed by primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI), the no-reflow phenomenon is assessed in different ways, according to studies. Nevertheless, it is well-established as a powerful predictor of poor prognosis. We sought to

Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention

Background Primary Percutaneous coronary intervention (PPCI) is an established mainstay in treatment of patients presenting with acute ST elevation myocardial infarction (STEMI). However, successful revascularization of the culprit coronary vessel does not always mean ideal myocardial reperfusion in a portion of patients, mainly because of the no-reflow phenomenon. Myocardial no-reflow is associated with worse contractile dysfunction and higher incidence of complications and is an independent predictor of death and myocardial infarction after PPCI. Objective: To study the relationship between admissions CRP, Albumin, CRP/Albumin ratio, Monocyte, HDL, and Monocyte/HDL ratio, in patients presenting with acute STEMI and angiographic no-reflow after PPCI. Material and Methods: From October 2018 to February 2019, of the 1500 patients who presented with STEMI for PPCI to any of the Ain Shams University Hospitals’ cath labs, we enrolled 150 consecutive patients who had post revascularization angiographic no-reflow. They were allocated to group A. we allocated 150 age, gender, and baseline characteristics matched STEMI patients who had TIMI III flow post revascularization to group B. this was set as the control group. Results: The study population was divided into 2 groups: no-reflow “A” (n = 150) and reflow “B” (n = 150) groups. CRP and Monocytes were significantly higher in the no-reflow group; Albumin and HDL were significantly lower in the no-reflow group. The novel indices, CRP/Albumin ratio (CAR) and Monocytes/HDL ratio (MHR) were both significantly higher in the no-reflow group (p value = 0.000) for both. The tow indices were found to be independent predictors of no-reflow development. Conclusion: Our results suggested that CAR and MHR on admission before PPCI though cheap, and easily measurable laboratory tools, have a significant predictive value with an odds ratio of 0.182 with a p value = 0.000 and 0.321 with a p value = 0.002 respectively. They could help to risk stratify STEMI patients who might suffer from no-reflow phenomenon after PPCI.

To evaluate the clinical and procedural predictors of no-reflow phenomenon following percutaneous coronary intervention for ST elevation myocardial infarction

To evaluate the clinical and procedural predictors of no-reflow phenomenon following percutaneous coronary intervention for ST elevation myocardial infarction

The predictors of no reflow phenomenon after percutaneous coronary intervention in patients with ST elevation myocardial infarction: A meta-analysis

ObjectiveTo investigate the no reflow risk factors after percutaneous coronary intervention in ST elevation myocardial infarction patients. MethodSample size, mean±standard deviation (SD) or frequencies (percent) of normal and no reflow groups were extracted from each study. ResultsOf 27 retrospective and prospective studies, we found that increasing risks of no reflow were associated with advanced age, male, family history of coronary artery disease, smoking, diabetes mellitus, hypertension, delayed reperfusion, killip class ≥2, elevated blood glucose, increased creatinine, elevated creatine kinase (CK), higher heart rate, decreased left ventricular ejection fraction (LVEF), collateral flow ≤1, longer lesion length, multivessel disease, reference luminal diameter, initial thrombolysis in myocardial infarction (TIMI) flow, and high thrombus burden. Moreover, initial TIMI flow ≤1 and high thrombus burden had the greater impact on no reflow (OR95%CI=3.83 [2.77–5.29], p<0.0001 and 3.69 [2.39–5.68], p<0.0001, respectively). ConclusionOur meta-analysis reveals that initial TIMI flow ≤1 and high thrombus burden are the most impacted no reflow risk factors.

TCT-723 Clinical and Angiographic Predictors of No-Reflow Phenomenon in ST Segment Elevation Myocardial Infarction Treated with Successful Primary Percutaneous Intervention

In ST segment elevation myocardial infarction (STEMI) primary percutaneous coronary intervention remains the optimal treatment modality to restore normal epicardial coronary artery blood flow. However, despite successful PCI a small, but still significant proportion of patients continue to present

The Predictors of No-Reflow Phenomenon after Primary Angioplasty for Acute Myocardial Infarction

The Predictors of No-Reflow Phenomenon after Primary Angioplasty for Acute Myocardial Infarction

Evaluation of clinical and angiographic characteristics of no reflow phenomenon after emergency PCI in AMI patients

Objective To investigate the clinical and angiographic characteristics of no reflow phenomenon after primary percutaneous coronary intervention (PCI) with acute myocardial infarction (AMI). Methods A total of 319 patients with AMI undergoing primary-PCI was divided into no-reflow and normal reflow groups. The incidence of no-reflow phenomenon, the clinical date, angiography findings, and surgical date were compared between two groups. Results No-reflow phenomenon occurred in forty(13.4%)of the patients after primary PCI. There was dramatic difference in combined hyperlipidemia, angina pectoris history before AMI, heart function ≥2 grades on admission, the length of the vascular lesions, vascular stenosis degree, blood clot load level, coronary artery opening time, and the expansion of the balloon between no-reflow and normal blood flow groups. Multiple logistic regression analysis identified that angina pectoris history before AMI, heart function classification on admission, high thrombus burden, the expansion of the balloon, and coronary artery opening time on angiography as independent predictors of no-reflow phenomenon. Conclusions The occurrence of no-reflow phenomenon after primary PCI was associated with high cholesterol history, no history of pre-infarction angina, heart function classification on admission, long vascular lesions, narrow degree of heavy, blood clots in the high load, coronary artery opened long time, and the expansion of the balloon more frequently. Key words: Myocardial infarction/TH/PP; Angioplasty, transluminal, percutaneous coronary

TCT-237 Effect of Thrombus Burden and its Residue on No-reflow Phenomenon After Manual Thrombectomy in ST-elevation Myocardial Infarction Patients

Large thrombotic burden is a well-known predictor of no-reflow phenomenon and mortality in ST-elevation myocardial infarction (STEMI). However, limited data are available on the clinical significance of residual thrombus after thrombectomy. Therefore, we aimed to investigate the effectiveness of

AS-274: Predictors of No-Reflow Phenomenon after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction and Plaque Rupture

AS-274: Predictors of No-Reflow Phenomenon after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction and Plaque Rupture