PMID- 20819117
OWN - NLM
STAT- MEDLINE
DCOM- 20110602
LR  - 20220409
IS  - 1540-8183 (Electronic)
IS  - 0896-4327 (Linking)
VI  - 23
IP  - 5
DP  - 2010 Oct
TI  - No-reflow phenomenon following percutaneous coronary intervention for acute 
      myocardial infarction: incidence, outcome, and effect of pharmacologic therapy.
PG  - 429-36
LID - 10.1111/j.1540-8183.2010.00561.x [doi]
AB  - BACKGROUND: No-reflow (NR) phenomenon is a well-known problem, often accompanying 
      percutaneous coronary intervention for acute ST elevation myocardial infarction 
      (STEMI). There are little data on effects of pharmacologic therapy on the 
      resolution, outcome, and long-term natural history of NR. OBJECTIVE: 
      Retrospectively assess incidence, management, and prognosis of NR in a tertiary 
      referral hospital. METHODS: Study included patients with STEMI, treated with 
      percutaneous coronary intervention (PCI). Effect of pharmacologic therapy and 
      long-term outcome were assessed. NR was defined by thrombolysis in myocardial 
      infarction (TIMI) < 3 or myocardial blush grade (MBG) < 3. RESULTS: Of 347 
      identified subjects, NR occurred in 110 (32%) by TIMI and 198 (57%) by MBG. 
      Higher incidence was identified in men versus women (34% vs. 25% by TIMI, P = 
      0.08; and 60% vs. 48% by MBG, P = 0.04). Pharmacologic therapy was equally 
      effective in restoring normal flow, increasing TIMI score from 1.62 +/- 0.07 to 
      2.78 +/- 0.06 (P < 0.0001) and MBG score from 0.43 +/- 0.08 to 2.09 +/- 0.11 (P < 
      0.0001). Twenty-three percent who did not receive pharmacologic therapy developed 
      clinical composite of congestive heart failure, cardiogenic shock, and/or death; 
      only 9% of patients who received pharmacologic therapy developed this composite. 
      Patients with severe NR despite treatment had poorer prognosis. Sixty-five 
      percent of patients who survived and had repeat angiogram about 1.5 years later 
      had spontaneous improvement in coronary flow by MBG. CONCLUSION: NR is common in 
      STEMI. Treatment with nicardipine, nitroprusside, and verapamil are equally 
      effective in improving flow. If not treated, prognosis is poor.
CI  - (c)2010, Wiley Periodicals, Inc.
FAU - Rezkalla, Shereif H
AU  - Rezkalla SH
AD  - Department of Cardiology, Marshfield Clinic, Marshfield, Wisconsin 54449, USA. 
      rezkalla.shereif@marshfieldclinic.org
FAU - Dharmashankar, Kodlipet C
AU  - Dharmashankar KC
FAU - Abdalrahman, Ihab B
AU  - Abdalrahman IB
FAU - Kloner, Robert A
AU  - Kloner RA
LA  - eng
PT  - Journal Article
DEP - 20100831
PL  - United States
TA  - J Interv Cardiol
JT  - Journal of interventional cardiology
JID - 8907826
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Vasodilator Agents)
RN  - 169D1260KM (Nitroprusside)
RN  - CJ0O37KU29 (Verapamil)
RN  - CZ5312222S (Nicardipine)
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - Calcium Channel Blockers/therapeutic use
MH  - Cardiac Catheterization
MH  - Female
MH  - *Fractional Flow Reserve, Myocardial
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/drug therapy/*therapy
MH  - Nicardipine/therapeutic use
MH  - Nitroprusside/therapeutic use
MH  - Prognosis
MH  - Retrospective Studies
MH  - Time Factors
MH  - Treatment Outcome
MH  - Vasodilator Agents/therapeutic use
MH  - Verapamil/therapeutic use
EDAT- 2010/09/08 06:00
MHDA- 2011/06/03 06:00
CRDT- 2010/09/08 06:00
PHST- 2010/09/08 06:00 [entrez]
PHST- 2010/09/08 06:00 [pubmed]
PHST- 2011/06/03 06:00 [medline]
AID - JOIC561 [pii]
AID - 10.1111/j.1540-8183.2010.00561.x [doi]
PST - ppublish
SO  - J Interv Cardiol. 2010 Oct;23(5):429-36. doi: 10.1111/j.1540-8183.2010.00561.x. 
      Epub 2010 Aug 31.