NCDR Study Shows No-Reflow During PCI Results in Higher Mortality, Adverse Outcomes
A study published on Jan. 30 in the American Journal of Cardiology found that patients who developed the no-reflow phenomenon during percutaneous coronary intervention (PCI) had higher rates of major adverse clinical outcomes, including in-hospital mortality, reinfarction, cardiogenic shock and heart failure (HF) compared with those who did not develop no-reflow, although the incidence of no-reflow was found to be low.
Also greater in the no-reflow patients was the rate of reinfarction (2.4 vs. 0.7 percent), new-onset cardiogenic shock (7.4 vs. 1.7 percent) and HF (5.2 percent vs. 2.1 percent). In addition, the infarct size was larger among the no-flow patients (median 133 vs. 76 ng/ml; p<0.0001).
"To date, the present report is the largest study of the no-reflow phenomenon among patients with AMI undergoing PCI," the authors note. They conclude that "the development of no-reflow, although relatively uncommon during PCI for AMI, is associated with adverse clinical outcomes. Upfront strategies to reduce the incidence of no-reflow could be considered for high-risk patients to improve outcomes."
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