Association of the Scottish Inflammatory Prognostic Score With the No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction

No-reflow is a serious complication of PPCI in STEMI. Systemic inflammation plays a role, but simple prognostic tools are needed. The Scottish Inflammatory Prognostic Score (SIPS), combining neutrophil count and serum albumin, shows promise in other areas but hasn’t been tested for no-reflow. The present study aimed to investigate the association between admission SIPS and angiographic no-reflow in STEMI patients undergoing PPCI. One thousand eighteen consecutive STEMI patients undergoing PPCI between 2020 and 2025 were analysed. SIPS was calculated on admission. No-reflow was defined as post-procedural thrombolysis in myocardial infarction (TIMI) flow <3 without mechanical obstruction. Associations were assessed using chi-square, receiver operating characteristic (ROC) analysis, and multivariate logistic regression. No-reflow occurred in 132 patients (13.0%), increasing with SIPS: 10.2% (low), 15.9% (moderate), 16.5% (high; P = .022). SIPS had modest discriminative ability (area under Curve [AUC] = 0.563, P = .019), similar to neutrophil count. Diabetes was independently linked to no-reflow (OR 1.30, P = .032); SIPS categories were not. Higher admission SIPS was associated with increased no-reflow risk in a graded pattern but did not emerge as an independent predictor after multivariable adjustment. DM was the sole independent predictor identified.