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

• Published in: Cardiovascular revascularization medicine Vol. 17; no. 8; pp. 552 - 555
• Main Authors: Levi, Yaniv, Sultan, Ayyaz, Alemayehu, Mistre, Wall, Sabrina, Lavi, Shahar
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2016
• Subjects: Acute MI; Aged; Angiography; Cardiovascular; Case-Control Studies; Endothelium, Vascular - physiopathology; Female; Humans; Hyperemia - physiopathology; Male; Manometry; Microcirculation; Middle Aged; No-reflow; No-Reflow Phenomenon - diagnosis; No-Reflow Phenomenon - etiology; No-Reflow Phenomenon - physiopathology; Ontario; Percutaneous Coronary Intervention - adverse effects; Predictive Value of Tests; Prospective Studies; Regional Blood Flow; Risk Factors; ST Elevation Myocardial Infarction - diagnosis; ST Elevation Myocardial Infarction - physiopathology; ST Elevation Myocardial Infarction - therapy; Stroke Volume; Treatment Outcome; Upper Extremity - blood supply; Angiography; No-reflow; Acute MI
• DOI: 10.1016/j.carrev.2016.08.013
• ISSN: 1553-8389; 1878-0938

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. 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) 48–72h post PCI using the EndoPAT device. 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). Systemic peripheral endothelial function does not differ between STEMI patients with and without no reflow during primary PCI. •This study assessed the association between endothelial dysfunction and no reflow.•Thirty consecutive patients with ST elevation myocardial infarction (STEMI) and normal flow were compared to 19 consecutive patients who had no reflow.•Peripheral endothelial function was assessed by reactive hyperemia index (RHI) 48–72h post procedure.•Peripheral endothelial function does not differ between STEMI patients with and without no reflow during primary PCI.