he aim of treatment for acute myocardial infarction (AMI) is to restore full antegrade blood flow in the infarct-related artery (IRA) and minimize ischemic damage to the myocardium. Thrombolytic therapy is an option, but primary percutaneous coronary intervention (PCI) is the treatment of choice, based on lower rates of recurrent ischemia or infarction and good success rates in restoring antegrade blood flow in the IRA. 1,2 However, primary PCI is associated with a serious problem known as the no-reflow phenomenon (Thrombolysis In Myocardial Infarction (TIMI) flow ≤2), which occurs in 5-25% of cases. 3,4 Although PCI achieves full patency of epicardial arteries, patients who develop this phenomenon are at increased risk for left ventricular dysfunction, more progressive myocardial damage, and have higher rates of morbidity and mortality. 5,6 A number of studies have focused on the risk factors, but most of those investigators used nuclear imaging techniques, 7 myocardial contrast echocardiography, 8 Doppler flow measurements, 9 TIMI frame count method 10 or myocardial blush grade 11 to assess no-reflow phenomenon.Although these techniques have greater accuracy for detecting post-PCI suboptimal reperfusion, TIMI flow grade is the easiest and most commonly used method of evaluating primary PCI success. 12 The aim of this study was to identify simple clinical factors, angiographic findings and procedural features that predict no-reflow phenomenon in patients with AMI who undergo primary PCI. Methods Study PopulationThis prospective observational study was conducted in the Cardiology Department of Kartal Kosuyolu Yuksek Ihtisas Education and Research Hospital between January 2003 and February 2006. During this period, emergency cardiac catheterization was performed in 612 patients who (1) presented with AMI of ≤12 h duration or (2) were admitted between 12 and 24 h after onset with signs and symptoms of continuing ischemia. Exclusions were: patients treated conservatively for coronary artery spasm or ≤50% diameter stenosis of the culprit lesion with normal coronary blood flow; patients who required emergency surgical revascularization for severe left main coronary artery or Circ J 2008; 72: 716 -721 (Received May 15, 2007; revised manuscript received December 7, 2007; accepted December 25, 2007) Background The aim of the study was to identify clinical factors, angiographic findings, and procedural features that predict no-reflow phenomenon (Thrombolysis In Myocardial Infarction (TIMI) flow grade ≤2) in patients with acute myocardial infarction (AMI) who undergo primary percutaneous coronary intervention (PCI). Methods and Results A series of 382 consecutive patients with AMI underwent primary PCI within 12 h of symptom onset. Patients with ischemic symptoms continuing for more than 12 h were also included. Clinical, angiographic and procedural data were collected for each subject. Ninety-three (24.3%) of the patients developed no-reflow phenomenon, and their findings were compared with those of the reflow grou...

Fragmentation in the resting ECG is associated with significant intraventricular dyssynchrony in patients with nonischemic cardiomyopathy, narrow QRS and sinus rhythm. Fragmentation in ECG might be useful in identifying patients who could benefit from cardiac resynchronization therapy.

Lower concentrations of Hb on admission are associated with higher rates of in-hospital mortality, heart failure and major bleeding after p-PCI.

Impaired brachial artery FMD is associated with long-term cardiovascular events and in-stent restenosis in patients undergoing PCI. Noninvasive assessment of endothelial function may serve as a surrogate marker for the estimation of future cardiovascular event risk and long-term follow-up in these patients.

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