title: No-reflow reversibility: a study based on serial assessment of multiple biomarkers.
abstract: No-reflow after primary percutaneous coronary intervention (pPCI) may be reversible. 40 patients undergoing pPCI were evaluated by assessing either improvement or lack of changes regarding angiographic and electrocardiographic indexes of no-reflow between admission and pre-discharge. Myeloperoxidase (MPO; in nanograms per milliliter), C-reactive protein (CRP; in milligrams per liter), endothelin-1 (ET-1; in nanograms per milliliter), angiopoietin-2 (Ang-2, in picograms per milliliter), and their pre-discharge/basal values variations (Δ) were related to no-reflow evolution. ΔMPO and ΔCRP were greater in patients with sustained no-reflow or lack of ST-segment resolution (STR) as compared with those with reversible no-reflow or lack of STR (p = 0.033, p = 0.04, p < 0.001, and p = 0.001, respectively), whereas ΔET-1 was similar in the two groups. ΔAng-2 was greater in patients with sustained no-reflow or lack of STR as compared with those with reversible no-reflow or lack of STR (p = 0.01 and 0.044, respectively). Bigger ΔMPO, ΔCRP (increasing levels), and ΔAng-2 (decreasing levels) are associated with sustained no-reflow, thus they might have a role in no-reflow evolution.
authors.affiliation: Institute of Cardiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy, gniccoli73@hotmail.it.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.forename: Francesco
authors.initials: F
authors.lastname: Fracassi
authors.forename: Nicola
authors.initials: N
authors.lastname: Cosentino
authors.forename: Elena
authors.initials: E
authors.lastname: Falcioni
authors.forename: Marco
authors.initials: M
authors.lastname: Roberto
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Anna
authors.initials: A
authors.lastname: Severino
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D003326:Coronary Circulation; D004562:Electrocardiography; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D010351:Patient Discharge; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D009195:Peroxidase / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D013997:Time Factors; D033921:Vesicular Transport Proteins / Q000097:blood*
chemical_list: D015415:Biomarkers; D019332:Endothelin-1; D018836:Inflammation Mediators; C555023:VPS51 protein, human; D033921:Vesicular Transport Proteins; D002097:C-Reactive Protein; D009195:Peroxidase