the assessment of no-reflow phenomenon incidence in early versus delayed percutaneous coronary intervention following a primary fibrinolysis

Background: percutaneous coronary intervention (pci) is the gold standard approach to st-segment elevation myocardial infarction (stemi). fibrinolysis followed by pci has been recommended. the current study aims to investigate the no-reflow phenomenon incidence in patients undergoing post-thrombolytic therapy pci.methods: this cross-sectional study was conducted on 250 patients with stemi who primarily received fibrinolytic therapy followed by early (3-24 hours) (n=231) or delayed (> 24 hours) (n=19) pci. they were also subcategorized into four intervals: <6 hours (n=98), 6-12 hours (n=93), 12-24 hours (n=38), and ≥24 hours (n=21). the demographic and medical data of the patients were retrieved. the thrombolysis in myocardial infarction score (timi) was assessed at baseline and at the end of pci. a timi score other than 3 was defined as no-reflow.results: the incidence of the no-reflow phenomenon was not associated with any of the underlying demographic and medical characteristics of the patients (p-value>0.05). despite the significantly higher rate of improvement in timi grading among those undergoing early pci (p-value=0.04), as well as within less than 6 hours after thrombolytic therapy (p-value=0.031), the rate of the no-reflow phenomenon did not differ between the groups, neither by sorting them as early versus delayed (p-value=0.518) nor by categorizing them into four intervals (p-value=0.367).conclusion: based on the findings of the current study, early pci after fibrinolysis led to significantly improved timi flow. however, the incidence of no-reflow did not differ between the groups with early versus delayed post-fibrinolysis pci.