Predictive Factors of the No Reflow Phenomenon during ST-Elevation Myocardial Infarction: Case Reports and Literature Review

The no-reflow phenomenon, defined as inadequate myocardial perfusion despite successful coronary recanalization, remains a significant complication following primary angioplasty for STEMI. This retrospective study analyzes 10 clinical cases, highlighting predictive factors such as high thrombotic burden (70% of cases), significant comorbidities (diabetes 50%, hypertension 40%, smoking 60%), persistent left ventricular dysfunction (average LVEF 40%), and prolonged revascularization delays (>6 hours in 50% of cases). The observations emphasize the central role of microvascular dysfunction and the complexity of no-reflow pathophysiology. Compared to the existing literature, our findings underscore the importance of targeted preventive strategies and innovative therapeutic approaches to improve clinical outcomes. Prospective validation in larger cohorts is needed to confirm these results.