PRIMARY CORONARY ANGIOPLASTY IN ACUTE MYOCARDIAL-INFARCTION - CLINICAL CORRELATES OF THE NO-REFLOW PHENOMENON

The purpose of this study was to assess clinical correlates of the 'no reflow' phenomenon in 21 consecutive patients with acute myocardial i nfarction and complete occlusion of the infarct related artery (TIMI 0 flow) that underwent successful direct PTCA. After successful recanal ization, 11 patients (group I) maintained TIMI 3 flow and ten patients presented with the 'no reflow' phenomenon (Group IT). New Q wave on t he surface ECG appeared in six patients in group I and in nine patient s in group II (P=NS), clinical and radiologic signs of cardiac failure were detected in two patients in group I and in seven patients in gro up II (P<0.03). Early recurrence of ischemia was reported in three pat ients of group II but not in group I (P=NS). We conclude that the 'no reflow' phenomenon occurs in about half the cases of direct PTCA for c omplete occlusion and predicts adverse clinical events. (C) 1998 Elsev ier Science Ireland Ltd.