Omar Aitmokhtar, Franck Paganelli, Saida Benamara, Adel Azaza, Laurent Bonello, Ouafa Hamza, Saber Seddiki, Tayeb Benathmane, Mourad Saidane, Ahmed Bouzid, Maamar Kara, Arezki Sik, Abdelmalek Azzouz, Faiza Harbi, Jean-Jacques Monsuez, Salim Benkhedda
BACKGROUND: High P2Y12 platelet reactivity (PR) level after primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) affects prognosis and may induce the no-reflow phenomenon. AIM: To investigate the role of PR in the genesis of microvascular obstruction. METHODS: Patients with STEMI undergoing PPCI within 12hours of symptoms onset were included prospectively. All patients received a 600mg clopidogrel-loading dose before PPCI and 250mg aspirin...
November 2017: Archives of Cardiovascular Diseases
Stavroula Papapostolou, Nick Andrianopoulos, Stephen J Duffy, Angela L Brennan, Andrew E Ajani, David J Clark, Christopher M Reid, Melanie Freeman, Martin Sebastian, Laura Selkrig, Matias B Yudi, Samer Q Noaman, William Chan
AIMS: The aim of the study was to evaluate long-term outcomes of transient versus persistent no-reflow. METHODS AND RESULTS: A total of 17,547 patients with normal flow post percutaneous coronary intervention (PCI) were compared to 590 patients (3.2%) with transient no-reflow and 144 patients (0.8%) with persistent no-reflow. Long-term all-cause mortality was obtained by linkage with the National Death Index (NDI). No-reflow patients were more likely to have presented with ST-elevation myocardial infarction (STEMI), out-of-hospital cardiac arrest (OHCA) or cardiogenic shock (all p<0...
June 20, 2018: EuroIntervention
Robert A Kloner
No abstract text is available yet for this article.
December 14, 2017: European Heart Journal
Rocco A Montone, Giampaolo Niccoli, Silvia Minelli, Francesco Fracassi, Vincenzo Vetrugno, Cristina Aurigemma, Francesco Burzotta, Italo Porto, Carlo Trani, Filippo Crea
AIMS: Microvascular obstruction (MVO) is associated with a worse prognosis in patients with ST-elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI). However, data about incidence, clinical outcome and correlates of MVO in latecomers after STEMI are still lacking. METHODS: We prospectively enrolled consecutive patients that were latecomers after STEMI (symptoms onset >12h) undergoing PCI. We performed an angiographic analysis to assess the occurrence of MVO [defined as TIMI flow grade ≤2 or 3 with a myocardial blush grade <2]...
June 1, 2017: International Journal of Cardiology
Shereif H Rezkalla, Rachel V Stankowski, Jennifer Hanna, Robert A Kloner
At the conclusion of a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, and after the cardiologist makes certain that there is no residual stenosis following stenting, assessment of coronary flow becomes the top priority. The presence of no-reflow is a serious prognostic sign. No-reflow can result in poor healing of the infarct and adverse left ventricular remodeling, increasing the risk for major adverse cardiac events, including congestive heart failure and death...
February 13, 2017: JACC. Cardiovascular Interventions
Suzanne de Waha, Manesh Patel, Christopher Granger, E Magnus Ohman, Akiko Maehara, Ingo Eitel, Ori Ben-Yehuda, Paul Jenkins, Holger Thiele, Gregg Stone
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Sanjiv Gupta, Madan Mohan Gupta
Percutaneous coronary intervention (PCI) is effective in opening the infarct related artery and restoring thrombolysis in myocardial infarction flow 3 (TIMI-flow 3) in large majority of ST-elevation myocardial infarction (STEMI). However there remain a small but significant proportion of patients, who continue to manifest diminished myocardial reperfusion despite successful opening of the obstructed epicardial artery. This phenomenon is called no-reflow. Clinically it manifests with recurrence of chest pain and dyspnea and may progress to cardiogenic shock, cardiac arrest, serious arrhythmias and acute heart failure...
July 2016: Indian Heart Journal
Baris Sensoy, Sezen Baglan Uzunget, SadikKadri Acikgoz, Nur Sensoy, Fatih Sen, Burak Acar, Uğur Canpolat, Ozcan Ozeke, Serkan Cay, Orhan Maden
BACKGROUND: No-reflow is a frequent complication during percutaneous coronary intervention (PCI) for acute ST segment elevation myocardial infarction (STEMI). Available data is limited regarding its impact on short-term outcomes in patients undergoing manual thrombus aspiration. Renal impairment is also associated with higher complication rates in STEMI. Herein, we aimed to evaluate the impact of baseline renal dysfunction on the no- reflow phenomenon and the association of no-reflow phenomenon with early clinical outcomes...
March 2016: Acta Cardiologica Sinica
Tsunenari Soeda, Takumi Higuma, Naoki Abe, Masahiro Yamada, Hiroaki Yokoyama, Shuji Shibutani, Daniel S Ong, Rocco Vergallo, Yoshiyasu Minami, Hang Lee, Ken Okumura, Ik-Kyung Jang
AIMS: Myocardial no reflow after percutaneous coronary intervention (PCI) is associated with poor outcome. Patients with ST-segment elevation myocardial infarction (STEMI) caused by plaque rupture are at high risk for no reflow. However, specific morphologic characteristics associated with no reflow are unknown in this population. The aim of this study is to identify the morphological characteristics of culprit plaques associated with no reflow in patients with STEMI caused by plaque rupture using both optical coherence tomography (OCT) and intravascular ultrasound (IVUS)...
January 2017: European Heart Journal Cardiovascular Imaging
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