No-reflow in Patients with ST Elevation Acute Anterior Myocardial Infarction

Objective: The aim of this study was to assess the prevalence of no-reflow after coronary recanalization in anterior acute myocardial infarction with ST-T segment elevation.
Methods: In a cohort of 80 consecutive patients with anterior acute myocardial infarction who were treated with primary angioplasty, we analysed angiographic and clinical characteristic of patients and the prevalence of pre-infarction angina. Successful angioplasty was defined as Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow and residual stenosis less than 50% after the angioplasty procedure. The phenomenon of no-reflow is defined as inadequate myocardial perfusion through a given segment of the coronary circulation without angiographic evidence of mechanical vessel obstruction.
Results: Successful angioplasty was achieved in 63 patients (78.75%). Mean age and gender were not different from patients with and without TIMI grade 3 flow. The no-reflow phenomenon was more frequently observed in patients with diabetes (29.41% vs 4.76%, p 0.0001). TIMI grade III flow was higher in the patients with pre-infarction angina (42.86% vs 11.76% p 0.02).
Conclusion: The no reflow phenomenon in patients with anterior acute myocardial infarction treated with primary angioplasty is present in 21.25% of patients. Pre-infarction angina is associated with preservation of the microvasculature, reflected by reduced no-reflow.