Prevalence and Predictors of No-Reflow Phenomenon in Patients with Acute Coronary Syndrome in Slemani Cardiac Hospital

Background and objectives: Understanding factors linked to the no-reflow phenomenon after percutaneous coronary intervention in acute coronary syndromes is important for optimizing reperfusion strategies. The aim of this study is to determine the prevalence and predictors of no-reflow phenomenon in Slemani Cardiac Hospital. Methods: This investigation was a prospective study that was carried out in Slemani Cardiac Hospital; between July 2023 until December 2023, of 150 acute coronary syndrome patients undergoing percutaneous coronary intervention collected data on demographics, clinical characteristics, angiographic findings, and procedural details. Patients were categorized into reflow and no-reflow groups based on final Thrombolysis in Myocardial Infarction flow. Associations between no-reflow and various parameters were analyzed. Results: There was 70% male, with 21.3% hypertension, 4% diabetes, 3.3% dyslipidemia. Common presentations were non-ST elevation myocardial infarction (41.3%), inferior ST elevation myocardial infarction (28%). No significant lesions were seen in 32%. Reflow success rate was 94%, with 6% no-reflow. No-reflow associated with risk factors like dyslipidemia, hypertension, diabetes, and smoking, but not angiographic/procedural variables. Conclusion: Cardiovascular risk factors emerged as key determinants of no-reflow, underscoring the importance of risk modification. The excellent reflow rates and lack of angiographic associations contrast some prior data, warranting further standardized research on no-reflow prediction and mechanisms to guide targeted interventions in acute coronary syndrome.