Prevalence and predictors of no-reflow in patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction at Al-Azhar University Hospitals, assiut

Backgroundand aim: Primary percutaneous coronary intervention is the reperfusion strategy of choice for restoring blood flow to the occluded coronary artery in patients with ST-elevation myocardial infarction. This study aimed to evaluate the prevalence and predictors of no-reflow in patients with ST-elevation myocardial infarction. Patients and methods: A cross-sectional study was conducted from January 2023 to December 2024 at Al-Azhar University Hospitals, Assiut, after permission from the Ethics Committee. Three hundred patients presenting with ST-elevation myocardial infarction and treated with primary percutaneous coronary intervention were included in the study. The study included patients who suffered from no-reflow and who did not have evidence of no-reflow. Results: Age was an important demographic factor, with no-reflow patients being significantly older ( P =0.021). While sex and smoking status showed no significant differences, both diabetes mellitus ( P =0.010) and hypertension ( P =0.011) were markedly more prevalent in the no-reflow group. Moreover, delayed presentation was significantly higher among patients with no-reflow ( P =0.041). Angiographic factors were also strongly associated with no-reflow, including lower baseline TIMI flow ( P =0.0201) and proximal lesions ( P =0.037). Prestent balloon inflation was not associated with no-reflow ( P =0.575). Conclusions: The incidence of no-reflow was notably higher among patients with advanced age, diabetes mellitus, hypertension, and delayed presentation, as indicated by demographic and clinical data as well as in patients with TIMI flow, proximal lesion location, and the use of longer stents.