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No-Reflow Reversibility: A Study Based on Serial Assessment of Multiple Biomarkers

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Abstract

No-reflow after primary percutaneous coronary intervention (pPCI) may be reversible. 40 patients undergoing pPCI were evaluated by assessing either improvement or lack of changes regarding angiographic and electrocardiographic indexes of no-reflow between admission and pre-discharge. Myeloperoxidase (MPO; in nanograms per milliliter), C-reactive protein (CRP; in milligrams per liter), endothelin-1 (ET-1; in nanograms per milliliter), angiopoietin-2 (Ang-2, in picograms per milliliter), and their pre-discharge/basal values variations (Δ) were related to no-reflow evolution. ΔMPO and ΔCRP were greater in patients with sustained no-reflow or lack of ST-segment resolution (STR) as compared with those with reversible no-reflow or lack of STR (p = 0.033, p = 0.04, p < 0.001, and p = 0.001, respectively), whereas ΔET-1 was similar in the two groups. ΔAng-2 was greater in patients with sustained no-reflow or lack of STR as compared with those with reversible no-reflow or lack of STR (p = 0.01 and 0.044, respectively). Bigger ΔMPO, ΔCRP (increasing levels), and ΔAng-2 (decreasing levels) are associated with sustained no-reflow, thus they might have a role in no-reflow evolution.

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Authors and Affiliations

  1. Institute of Cardiology, Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, 00168, Rome, Italy

    Giampaolo Niccoli, Francesco Fracassi, Nicola Cosentino, Elena Falcioni, Marco Roberto, Antonio Maria Leone, Francesco Burzotta, Italo Porto, Carlo Trani, Anna Severino & Filippo Crea

  2. Division of Cardiology, “Maggiore della Carità” Hospital, Università del Piemonte Orientale “A. Avogadro”, Novara, Italy

    Giuseppe De Luca

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  1. Giampaolo Niccoli
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  2. Francesco Fracassi
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  3. Nicola Cosentino
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  4. Elena Falcioni
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Correspondence to Giampaolo Niccoli.

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Associate Editor Enrique Lara-Pezzi oversaw the review of this article

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Niccoli, G., Fracassi, F., Cosentino, N. et al. No-Reflow Reversibility: A Study Based on Serial Assessment of Multiple Biomarkers. J. of Cardiovasc. Trans. Res. 6, 798–807 (2013). https://doi.org/10.1007/s12265-013-9509-5

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