title: Association of endothelial dysfunction and no-reflow during primary percutaneous coronary intervention for ST-elevation myocardial infarction.
abstract: BACKGROUND
  Coronary no-reflow during primary percutaneous coronary intervention (PPCI) is a predictor of poorer cardiovascular outcome. Both endothelial dysfunction and no-reflow involves abnormal vascular function and hemostasis. Our aim was to assess the association between endothelial dysfunction and no reflow during primary PCI.
  
  
  METHODS
  Thirty consecutive patients with ST elevation myocardial infarction (STEMI) and normal flow during primary PCI were compared to 19 consecutive patients who had no reflow. All subjects underwent assessment of peripheral endothelial function by reactive hyperemia index (RHI) 48-72h post PCI using the EndoPAT device.
  
  
  RESULTS
  Age, sex and hypertension were similar in both groups. Smokers were less likely to have no-reflow. Post PPCI there was less ST segment resolution in the no-reflow group (48%±7 vs. 81%±6; p=0.001). Patients who had no reflow had subsequently lower ejection fraction (39%±10 vs. 47%±10; p=0.015). There was no difference in vascular function (RHI), between the no-reflow and normal flow groups (1.91±0.3 vs. 2.09±0.11; p=0.24).
  
  
  CONCLUSIONS
  Systemic peripheral endothelial function does not differ between STEMI patients with and without no reflow during primary PCI.
authors.affiliation: Western University, N6A 5A5 London, ON, Canada; London Health Sciences Centre, N6A 5A5 London, ON, Canada.
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Levi
authors.affiliation: Western University, N6A 5A5 London, ON, Canada; London Health Sciences Centre, N6A 5A5 London, ON, Canada.
authors.forename: Ayyaz
authors.initials: A
authors.lastname: Sultan
authors.affiliation: London Health Sciences Centre, N6A 5A5 London, ON, Canada.
authors.forename: Mistre
authors.initials: M
authors.lastname: Alemayehu
authors.affiliation: London Health Sciences Centre, N6A 5A5 London, ON, Canada.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Wall
authors.affiliation: Western University, N6A 5A5 London, ON, Canada; London Health Sciences Centre, N6A 5A5 London, ON, Canada. Electronic address: Shahar.Lavi@lhsc.on.ca.
authors.forename: Shahar
authors.initials: S
authors.lastname: Lavi
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D008365:Manometry; D008833:Microcirculation; D008875:Middle Aged; D054318:No-Reflow Phenomenon / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009864:Ontario; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012039:Regional Blood Flow; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013318:Stroke Volume; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply*
keywords: Acute MI; Angiography; No-reflow