Evidence map›Paper›PMID 40910963›Full record

ArticleJACC. Asia2025

Association and Prognostic Implications of "No-Reflow Phenomenon" and Hypercoagulability in Patients With ST-Segment Elevation Myocardial Infarction.

Mohamed Omar, Min Gyu Kang, Moon Ki Jung, Jong-Hwa Ahn, Jin-Sin Koh, Phil Iver Guevarra, Sang-Wook Kim, Udaya S Tantry, Paul A Gurbel, Jin-Yong Hwang and 1 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Asia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04650529 (G-NUH), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04650529 unknown statusnot on this map

G-NUH (Gyeongsang National University Hospital) Registry

Typeobservational_patient_registrySponsorGyeongsang National University HospitalRan2010 to 2025Enrolled10,000ConditionsPercutaneous Coronary Intervention, Hemostatic Disorder, Blood ClotArmsstent, ballooning
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Mohamed OmarHeart and Brain Hospital, Chung-Ang University Gwangmyeong Center, Gwangmyeong, South Korea; Cardiology Department, National Heart Institute of Egypt, Giza, Egypt.
Min Gyu KangDivision of Cardiology, Gyeongsang National University Hospital, Jinju, South Korea; Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea.
Moon Ki JungHeart and Brain Hospital, Chung-Ang University Gwangmyeong Center, Gwangmyeong, South Korea; Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
Jong-Hwa AhnDepartment of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea; Cardiovascular Center, Gyeongsang National University Changwon Hospital, Changwon, South Korea.
Jin-Sin KohDivision of Cardiology, Gyeongsang National University Hospital, Jinju, South Korea; Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea.
Phil Iver GuevarraHeart and Brain Hospital, Chung-Ang University Gwangmyeong Center, Gwangmyeong, South Korea.
Sang-Wook KimHeart and Brain Hospital, Chung-Ang University Gwangmyeong Center, Gwangmyeong, South Korea; Division of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea.
Udaya S TantrySinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, Maryland, USA.
Paul A GurbelSinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, Maryland, USA.
Jin-Yong HwangDivision of Cardiology, Gyeongsang National University Hospital, Jinju, South Korea; Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, South Korea.
Young-Hoon JeongDivision of Cardiology, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea; CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea. Electronic address: goodoctor@naver.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFollowing percutaneous coronary intervention (PCI), the "no-reflow phenomenon" is associated with a worse outcome. However, it remains unclear how to prevent and treat this phenomenon during PCI.

objectivesThis study aimed to evaluate the association between thrombogenicity profiles and "no-reflow phenomenon" during primary PCI in patients with ST-segment elevation myocardial infarction (STEMI).

methodsFrom a real-world registry, we prospectively enrolled patients with STEMI who underwent primary PCI (n = 334). TIMI flow grade was assessed at final angiography, and the "no-reflow phenomenon" was defined as TIMI flow grade between 0 and 2. Thrombogenicity profiles were assessed with thromboelastography (TEG) and conventional hemostatic measurements.

resultsThirty-seven patients (11.1%) showed no-reflow after primary PCI. High platelet-fibrin clot strength (P-FCS: ≥ 68 mm) measured by TEG was significantly associated with an increased risk of post-PCI "no-reflow phenomenon" (OR: 2.611; 95% CI: 1.220-5.584; P = 0.010). The risk stratification with "no-reflow phenomenon" and "high P-FCS phenotype" appeared to be additive to predict the risk of 3-year clinical event (log-rank P < 0.001 across the groups). Patients with both "no-reflow phenomenon" and high P-FCS had a higher risk of adverse clinical events compared with normal-reflow subjects with low P-FCS (adjusted HR: 6.654; 95% CI: 2.678-16.530; P < 0.001).

conclusionsThis study demonstrated a close relationship between heightened thrombogenicity (assessed by TEG P-FCS) with "no-reflow phenomenon," and their additive prognostic implications after primary PCI in STEMI patients. Effective control of clot strength may reduce the risk of "no-reflow phenomenon" and improve clinical outcomes in these patients. (Gyeongsang National University Hospital Registry [GNUH]; NCT04650529).

Indexed as

acute myocardial infarctioncardiovascular eventclot strengthno-reflow phenomenonpercutaneous coronary intervention

Identifiers

PMID40910963
PMCPMC12673828

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.