{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:31:52Z","timestamp":1793640712939,"version":"4.5.1"},"reference-count":47,"publisher":null,"issue":"2","license":[{"start":{"date-parts":[[2021,2,28]],"date-time":"2021-02-28T00:00:00Z","timestamp":1614470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/lib.ossn.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kardiologiia"],"abstract":"<jats:p>Despite successful and timely revascularization of the infarct-related artery, myocardial tissue remains underperfused in some patients. This condition is known as the no-reflow phenomenon, which is associated with a worse prognosis. The first part of the systematic review on no-reflow focuses on description of the no-reflow pathogenesis and predictors. This phenomenon has a complicated, multifactorial pathogenesis, including distal embolization, ischemic injury, reperfusion injury, and a component of individual predisposition. Meanwhile, this phenomenon undergoes spontaneous regression in some patients. Several studies have demonstrated the role of definite biomarkers and clinical indexes as risk predictors for no-reflow. The significance of each pathogenetic component of no-reflow is suggested to be different in different patients, which may warrant an individualized approach in the treatment.<\/jats:p>\n                  <jats:p>\u00a0<\/jats:p>","DOI":"10.18087\/cardio.2021.2.n1175","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T02:53:07Z","timestamp":1615776787000},"page":"99-105","source":"Crossref","is-referenced-by-count":7,"title":["The no-Reflow Phenomenon During Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction due to Massive Coronary Thrombosis. Pathogenesis and Predictors of no-Reflow"],"prefix":"10.68900","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9130-707X","authenticated-orcid":true,"given":"A. S.","family":"Zhuravlev","sequence":"first","affiliation":[{"name":"I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-337X","authenticated-orcid":true,"given":"A. V.","family":"Azarov","sequence":"additional","affiliation":[{"name":"I. M. Sechenov First Moscow State Medical University (Sechenov University), \r\nMoscow"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1268-5145","authenticated-orcid":true,"given":"S. P.","family":"Semitko","sequence":"additional","affiliation":[{"name":"I. M. Sechenov First Moscow State Medical University (Sechenov University), \r\nMoscow"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6425-7428","authenticated-orcid":true,"given":"D. G.","family":"Ioseliani","sequence":"additional","affiliation":[{"name":"I. M. 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Association between Endothelial Nitric Oxide Synthase Gene Polymorphism (Glu298Asp) and Coronary No-Reflow Phenomenon in Acute Myocardial Infarction. Advances in Hygiene & Experimental Medicine. 2019; [Epub ahead of print]. DOI: 10.5604\/01.3001.0013.5253","DOI":"10.5604\/01.3001.0013.5253"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Limbruno U, De Carlo M, Pistolesi S, Micheli A, Sonia Petronio A, Camacci T et al. Distal embolization during primary angioplasty: Histopathologic features and predictability. American Heart Journal. 2005;150(1):102\u20138. DOI: 10.1016\/j.ahj.2005.01.016","DOI":"10.1016\/j.ahj.2005.01.016"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Nallamothu BK, Bradley EH, Krumholz HM. Time to Treatment in Primary Percutaneous Coronary Intervention. New England Journal of Medicine. 2007;357(16):1631\u20138. 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