Predictors of no-reflow after coronary stenting in patients with high thrombus burden

Aims: In this study, we aimed to reveal the predictors of no-reflow after coronary stenting in patients with high thrombus burden. Methods: Patients with acute myocardial infarction who underwent stenting of a coronary lesion with high thrombus burden in the same session between February 2020 and July 2022 in our center were included in this retrospective study. High thrombus burden was accepted as Thrombolysis in Myocardial Infarction (TIMI) grade 4 or 5 thrombus. No-reflow was accepted as TIMI grade ≤2 flow at the end of the procedure. Multivariate logistic regression analysis was executed to ascertain the predictors of no-reflow. Results: Of the 485 patients included in the study, 407 (83.9%) did not develop no-reflow. Of the 78 (16.1%) patients who developed no-reflow at the end of the procedure, 61 had TIMI 2, 10 had TIMI 1, and 7 had TIMI 0 flow. Age [odds ratio (OR) 1.051; 95% confidence interval (CI) 1.021-1.082; p=.001], accumulated thrombus proximal to the occlusion (OR 3.318; 95% CI 1.176-9.365; p=.023), reference vessel diameter (RVD) greater than 4 mm (OR 2.569; 95% CI 1.005-6.565; p=.049), and TIMI flow grade after wiring or small balloon dilation (OR 0.108; 95% CI 0.065-0.181; p