{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:30:06Z","timestamp":1786613406644,"version":"build-2736575974"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The no-reflow phenomenon after percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) represents a major barrier to successful reperfusion, leading to adverse outcomes despite epicardial vessel patency. Comparative evidence regarding its incidence and clinical consequences between primary PCI and pharmaco-invasive PCI remains scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The study aimed to compare the incidence of the no-reflow phenomenon in patients undergoing pharmaco-invasive PCI versus primary PCI, and to evaluate the short-term clinical outcomes of patients with no-reflow at three months post-procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, single centre, observational study, STEMI patients presenting within 24\u2005h of symptom onset were enrolled at a tertiary care centre. Patients experiencing no-reflow were categorized into Group A (primary PCI;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200992) and Group B (pharmaco-invasive PCI;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009192). Baseline demographics, comorbidities, angiographic characteristics, and outcomes were analysed. The primary outcome was the incidence of major adverse cardiac events at three months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 857 patients undergoing primary PCI and 2,976 undergoing pharmaco-invasive PCI, the incidence of no-reflow was significantly higher in the primary PCI group (10.7% vs. 6.5%). Patients in Group A were older (58.9\u2009\u00b1\u200913.6 vs. 54.4\u2009\u00b1\u200911.4 years;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004) and more frequently diabetic (55.4% vs. 41.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.029), whereas hypertension was more prevalent in Group B (42.7% vs. 13.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Baseline TIMI 0 flow was more common in Group A (79.3% vs. 24.5%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). After PCI, final TIMI 3 flow rates were comparable (85.9% vs. 89.6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.361). In-hospital complications and three-month outcomes were similar between two groups: death (4.3% vs. 5.2%), revascularization (4.3% vs. 4.7%), and rehospitalization (5.4% vs. 3.1%) (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No-reflow was more frequent after primary PCI, particularly in older, diabetic, and late-presenting patients with baseline TIMI 0 flow. Both reperfusion strategies achieved comparable short-term clinical outcomes in no-reflow patients. Pharmaco-invasive PCI may mitigate the risk of no-reflow in selected STEMI patients while maintaining equivalent early prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1899340","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:10:15Z","timestamp":1786612215000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of no-reflow phenomenon in patients with ST-segment- elevation myocardial infarction undergoing primary PCI vs. pharmaco-invasive strategy: a single-centre study"],"prefix":"10.3389","volume":"13","author":[{"given":"Ayush","family":"Shukla","sequence":"first","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awadhesh Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akhil Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav Kumar","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umesh Chandra","family":"Tripathi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharad","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshyaya","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pravesh","family":"Vishwakarma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King George\u2019s Medical University","place":["Lucknow, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1016\/j.acvd.2015.09.006","article-title":"The no-reflow phenomenon: state of the art","volume":"108","author":"Bouleti","year":"2015","journal-title":"Arch Cardiovasc Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.2174\/157340312803217148","article-title":"Treating and preventing no reflow in the cardiac catheterization laboratory","volume":"8","author":"Berg","year":"2012","journal-title":"Curr Cardiol 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the answer to improving ST-elevation\u2013myocardial infarction care","volume":"9","author":"Mentias","year":"2020","journal-title":"J Am Heart Assoc"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1899340\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T09:10:16Z","timestamp":1786612216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1899340\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,13]]},"references-count":11,"alternative-id":["10.3389\/fcvm.2026.1899340"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1899340","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,13]]},"article-number":"1899340"}}