{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:07Z","timestamp":1786977487465,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify clinical and angiographic predictors of the no\u2010reflow phenomenon and evaluate its impact on short\u2010 and long\u2010term outcomes in patients undergoing primary percutaneous coronary intervention (PCI) for ST\u2010elevation myocardial infarction (STEMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 2925 patients who underwent primary PCI for STEMI between January 2020 and July 2025. Patients were stratified into no\u2010reflow and normal flow groups based on final TIMI flow. Baseline clinical, angiographic, and procedural data were analyzed. Multivariate logistic regression identified independent predictors of no\u2010reflow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The no\u2010reflow phenomenon occurred in 526 patients (18%). Independent predictors included older age, diabetes mellitus, Killip class \u2265 II, high thrombus burden, pre\u2010PCI TIMI 0 flow, and longer symptom\u2010to\u2010door time. Use of GP IIb\/IIIa inhibitors was protective. No\u2010reflow patients had higher in\u2010hospital mortality (17.3% vs. 4.5%), lower LVEF, and increased 1\u2010year MACE (40.5% vs. 16.4%). Kaplan\u2013Meier curves confirmed significantly reduced MACE\u2010free survival (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The no\u2010reflow phenomenon is associated with adverse outcomes and can be predicted using routine clinical and angiographic features. Early identification may enable targeted preventive strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70374","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T17:25:59Z","timestamp":1781544359000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and Angiographic Predictors of No\u2010Reflow and Its Impact on Outcomes in ST\u2010Elevation Myocardial Infarction: A Retrospective Study"],"prefix":"10.1002","volume":"49","author":[{"given":"Husnain","family":"Bashir","sequence":"first","affiliation":[{"name":"Department of Medicine Ibn e Seena Hospital Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. N. U.","family":"Berkha","sequence":"additional","affiliation":[{"name":"Department of Medicine Ibn e Seena Hospital Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9343-4187","authenticated-orcid":false,"given":"Jahanzeb","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Cardiology Abbas Institute of Medical Sciences Muzaffarabad Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3310-5442","authenticated-orcid":false,"given":"Abida","family":"Perveen","sequence":"additional","affiliation":[{"name":"Department of Medicine Ibn e Seena Hospital Kabul Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx393"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc0502.102867"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.09.015"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpcardio0632"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv484"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00865-2"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.12.054"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2018.01.032"},{"issue":"26","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000020152","article-title":"Prediction of No\u2010Reflow Phenomenon in Patients Treated With Emergency PCI","volume":"99","author":"Yang L.","year":"2020","journal-title":"Med (Baltimore)"},{"key":"e_1_2_12_11_1","article-title":"Predictors of No\u2010Reflow Phenomenon Development in STEMI Treated With Primary PCI: A Retrospective Tertiary\u2011Center Study","author":"D\u00f6nmez E.","year":"2023","journal-title":"Behav Med Bull"},{"issue":"6","key":"e_1_2_12_12_1","first-page":"435","article-title":"Novel Predictors and Adverse Long\u2011Term Outcomes of No\u2011Reflow Phenomenon in STEMI Undergoing PCI","volume":"72","author":"Refaat H.","year":"2020","journal-title":"Indian Heart Journal"},{"issue":"4","key":"e_1_2_12_13_1","first-page":"370","article-title":"Predictive Factors and Impact of No\u2010Reflow After Primary PCI on Long\u2010Term Outcomes","volume":"3","author":"Ndrepepa G.","year":"2010","journal-title":"Circulation: Cardiovascular Interventions"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2015.11.002"},{"issue":"11","key":"e_1_2_12_15_1","first-page":"e927","article-title":"Long\u2011Term Clinical Outcomes of Transient and Persistent No\u2011Reflow Following PCI","volume":"18","author":"Australian Multicentre Registry","year":"2022","journal-title":"EuroIntervention"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-025-03191-2"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/17520363.2025.2590790"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm15031063"},{"issue":"6","key":"e_1_2_12_19_1","first-page":"435","article-title":"Novel Inflammatory Biomarkers (CAR, FAR, AIP) Predicting No\u2011Reflow and Outcomes","volume":"72","author":"Refaat H.","year":"2020","journal-title":"Indian Heart 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