Platelet-derived growth factor-BB is a novel inflammatory biomarker of no-reflow in STEMI patients treated with primary PCI.

Despite timely primary percutaneous coronary intervention (pPCI), the no-reflow phenomenon (NRP) continues to adversely affect myocardial perfusion and outcomes in ST-segment elevation myocardial infarction (STEMI). While multiple mechanisms are implicated, reliable biomarkers for early prediction remain limited. Platelet-derived growth factor-BB (PDGF-BB), a cytokine involved in vascular inflammation and remodeling, is elevated in acute coronary syndromes. This study aimed to assess whether pre-procedural PDGF-BB levels could predict NRP in STEMI patients undergoing pPCI. In this prospective observational study, 80 STEMI patients undergoing pPCI were grouped by post-procedural TIMI flow: NRP(+) (TIMI ≤2; n=33) and NRP(−) (TIMI 3; n=47). Serum PDGF-BB levels were measured before angiography, and clinical, angiographic, and laboratory variables were compared. PDGF-BB levels were significantly higher in the NRP group (168.5 ± 177.3 vs. 65.5 ± 43.1 pg/mL; p=0.004), along with lower baseline TIMI flow (p=0.002), greater stent diameter (p=0.013), and more total occlusions (p=0.015). PDGF-BB remained an independent predictor in multivariate analysis (p=0.01). ROC analysis showed a cutoff of 89.99 pg/mL predicted NRP with 51.5% sensitivity and 87.2% specificity (AUC=0.688; p=0.004). Elevated pre-procedural PDGF-BB levels are independently associated with NRP in STEMI patients. Although its diagnostic performance is moderate, its high specificity may aid in identifying high-risk patients. Further validation and integration into risk models are warranted.