title: Long-Term Clinical Outcomes of Transient and Persistent No Reflow Phenomena following Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction.
abstract: OBJECTIVE
  There is limited information on the transient or persistent no reflow phenomenon in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI).
  
  
  METHODS
  The study analyzed 4329 patients with AMI from a Korean multicenter registry who underwent PCI using coronary stents (2668 ST-elevation and 1661 non-ST-elevation myocardial infarction [MI] patients): 4071 patients without any no reflow, 213 with transient no reflow (no reflow with final thrombolysis in myocardial infarction [TIMI] flow grade 3), and 45 with persistent no reflow (no reflow with final TIMI flow grade≤2). The primary endpoint was all-cause mortality during 3-year follow-up. We also analyzed the incidence of cardiac mortality, non-fatal MI, re-hospitalization due to heart failure, target vessel revascularization, and stent thrombosis.
  
  
  RESULTS
  The persistent no reflow group was associated with higher all-cause mortality (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.08-3.65, p=0.028) and cardiac mortality (HR 3.28, 95% CI 1.54-6.95, p=0.002) compared with the normal reflow group. Transient no reflow increased all-cause mortality only when compared with normal reflow group (HR 1.58, 95% CI 1.11-2.24, p=0.010). When comparing transient and persistent no reflow, persistent no reflow was associated with increased all-cause mortality (46.7 vs. 24.4%, log rank p=0.033).
  
  
  CONCLUSIONS
  The persistent no reflow phenomenon was associated with a poor in-hospital outcome and increased long-term mortality mainly driven by increased cardiac mortality compared to the transient no reflow phenomenon or normal reflow.
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Hae Chang
authors.initials: HC
authors.lastname: Jeong
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Youn
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.affiliation: Department of Cardiology, Seoul St Mary's Hospital, The Catholic University School of Medicine, Seoul, Korea.
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
authors.affiliation: Department of Cardiology, Seoul St Mary's Hospital, The Catholic University School of Medicine, Seoul, Korea.
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
keywords: Myocardial infarction; No-reflow phenomenon; Percutaneous coronary interventions