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Cardiovascular Drugs and Therapy
Published in: Cardiovascular Drugs and Therapy 5/2019

01-10-2019 | Myocardial Infarction | REVIEW ARTICLE

Pathophysiology, Diagnosis, and Management of the No-Reflow Phenomenon

Authors: Joseph Allencherril, Hani Jneid, Dan Atar, Mahboob Alam, Glenn Levine, Robert A. Kloner, Yochai Birnbaum

Published in: Cardiovascular Drugs and Therapy | Issue 5/2019

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Abstract

Successful reperfusion of an infarct-related coronary artery by primary percutaneous intervention or fibrinolysis during acute ST-elevation myocardial infarction (STEMI) does not always restore myocardial tissue perfusion, a phenomenon termed “no-reflow.” Herein we discuss the pathophysiology of this highly prevalent phenomenon and highlight the most salient aspects of its clinical diagnosis and management as well as the limitations of presently used methods. There is a great need for understanding the dynamic nature of no-reflow, as its occurrence is associated with poor cardiovascular outcomes. The no-reflow phenomenon may lend an explanation to the lack of further improvements in in-hospital mortality in STEMI patients despite decreases in door-to-balloon time. Hence, no-reflow potentially presents an important target for investigators interested in improving outcomes in STEMI.
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Metadata
Title
Pathophysiology, Diagnosis, and Management of the No-Reflow Phenomenon
Authors
Joseph Allencherril
Hani Jneid
Dan Atar
Mahboob Alam
Glenn Levine
Robert A. Kloner
Yochai Birnbaum
Publication date
01-10-2019
Publisher
Springer US
Published in
Cardiovascular Drugs and Therapy / Issue 5/2019
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-019-06901-0

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