The prognosis of patients with STEMI who develop coronary no-reflow phenomenon after primary PCI

Introduction: Following an acute myocardial infarcti-on, it is essential to perform primary PCI urgently to reperfusion the coronary artery involved, restoring op-timal flow to this level. However, the post stent implan-tation of a TIMI 0-1 flux and the presence of a MGB 0-1 translates the coronary no-reflow phenomenon with a negative prognosis.
Methods: A prospective study was conducted on 356 patients admitted to the County Emergency Clinical Hospital between 01.01.2016 and 31.12.2017 who pre-sented STEMI, and following primary PCI, 34 develo-ped coronary no-reflow phenomenon, followed later on 30.04.2018. The patients were clinically and para-clinically assessed: ECG and pre-post-PCI echocardio-graphy, TIMI and MGB flow assessment, and the epi-cardial coronary arteries involved.
Results: T he coronary no-reflow phenomenon was more frequently observed in males 52.9% (18) compa-red to women 47.05% (16), of which over 50 years were 79.4% (27) versus 20.5% (7) under this age. The artery involved in the infarction was predominantly ADA at 76.4% (26), followed by ACD 17.6% (6) and ACX 5.8% (2). In the short term, 5.8% (2) exhibit hemodynamic instability followed by cardiogenic shock and death, and heart failure is detected at autopsy. Electrocardi-ography 85.2% (29) highlighted the persistence of ST overgrowth with more than 50% of baseline at 4 days postPCI, and echocardiographic 44.1% (15) had left ventricular akinesia, 50% (17) had VS hypokinesia , and 5.8% (2) developed VS aneurysm. In the long run, hospitalization rates are rising in these patients, with 35.2% (12) rebounding from heart failure episodes.
Conclusions: Deletion of coronary no-reflow pheno-menon after primary PCI in patients with STEMI has a negative prognosis, both in the short and long term, the rate of hospitalizations being increasing as well as the long-term survival rate is low compared to those who do not develop phenomenon.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)
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