What is the clinical evidence from this study?

Study design: Cohort. Population: first acute myocardial infarction (n=120). Intervention: Angiographic no-reflow phenomenon vs. reflow (TIMI-3). Primary outcome: long-term cardiac death (RR 5.25, 95% CI 1.85 to 14.9, p=0.002).

What question did this study set out to answer?

This research aims to determine the long-term prognostic significance of the angiographic no-reflow phenomenon after percutaneous transluminal coronary angioplasty in acute myocardial infarction patients.

April 29, 2026Journal of the American College of Cardiology

Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction

Q: What are the key findings of this study?

Angiographic no-reflow phenomenon after PTCA for acute myocardial infarction independently predicted long-term cardiac death (RR 5.25; 95% CI 1.85 to 14.9; p=0.002) compared to reflow.

View Full Paper

Ask AI

Bookmark

Key result

No-reflow after PTCA for acute MI predicts ~425% higher long-term cardiac death risk versus reflow.

RR 5.25
95% CI 1.85 to 14.9
P=0.002
n=120

Why the study?

Although angiographic no-reflow predicts poor left ventricular recovery and early survival after acute myocardial infarction, its long-term prognostic importance remained to be elucidated.

Population

120 consecutive patients with first AMI treated by PTCA without flow-restricting lesions

Comparison

No-reflow (n = 30) vs reflow (TIMI-3, n = 90)

Design

Observational cohort study

Follow-up

5.8 +/- 1.2 years

Authors

IMItsuro MorishimaElectrophysiology TSTakahito SoneOgaki Municipal Hospital KOKenji OkumuraWestchester Medical Center

Discussion

Member takes

Implication

Prompts intensified long-term monitoring after no-reflow during PTCA for AMI; leaves open efficacy of interventions targeting microvascular dysfunction.

Key Points

This research aims to determine the long-term prognostic significance of the angiographic no-reflow phenomenon after percutaneous transluminal coronary angioplasty in acute myocardial infarction patients.
Studied 120 consecutive patients with first acute myocardial infarction treated by PTCA without flow-restricting lesions.
Patients were classified as no-reflow or reflow based on post-PTCA angiograms for 5.8 years.
Followed for cardiac death and nonfatal events.
No-reflow patients had a significantly higher rate of congestive heart failure (p < 0.0001) and cardiac death (p = 0.002) compared to reflow patients.
Kaplan-Meier analysis showed no-reflow patients had substantially lower cardiac survival (p < 0.0001).
Multivariate analyses indicated no-reflow phenomenon independently predicted long-term cardiac death (RR 5.25, 95% CI 1.85 to 14.9, p = 0.002) and cardiac events (RR 3.71, 95% CI 1.79 to 7.69, p = 0.0004).

Study Design

Type

Cohort (n=120)

PICO

Population

first acute myocardial infarction (n=120)

Intervention / Comparator

Angiographic no-reflow phenomenon vs reflow (TIMI-3)

Primary Outcome

long-term cardiac death — RR 5.25 (1.85 to 14.9), p=0.002

Main Result

Effect estimate: RR 5.25 (95% CI 1.85 to 14.9)

p-value: p=0.002

Cite This Study

Morishima et al. (2000) conducted a cohort in first acute myocardial infarction (n=120). Angiographic no-reflow phenomenon vs. reflow (TIMI-3) was evaluated on long-term cardiac death (RR 5.25, 95% CI 1.85 to 14.9, p=0.002). Angiographic no-reflow phenomenon after PTCA for acute myocardial infarction independently predicted long-term cardiac death (RR 5.25; 95% CI 1.85 to 14.9; p=0.002) compared to reflow.

synapsesocial.com/papers/69f178a2adb7394e289b489d https://doi.org/10.1016/s0735-1097(00)00865-2

View Full Paper

Ask AI

Bookmark

Implication

Prompts intensified long-term monitoring after no-reflow during PTCA for AMI; leaves open efficacy of interventions targeting microvascular dysfunction.

Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Also Consider

Also Consider