Current knowledge of no-reflow phenomenon after PCI in patients with acute ST-segment elevation myocardial infarction

Acute ST-segment elevation myocardial infarction (STEMI) is a catastrophic cardiovascular disease that threatens human health and life, with dangerous onset and high mortality. With the development of percutaneous coronary intervention (PCI), the revascularization of occluded arteries and the restoration of distal myocardial perfusion in short term can significantly reduce the mortality of STEMI patients and improve their clinical outcomes. However, a considerable number of STEMI patients may suffer from coronary no-reflow (CNR) phenomenon after revascularization, which greatly hinders the improvement of clinical therapy and long-term prognosis. Currently, the pathological mechanism of CNR is still unclear and there is a lack of reliable clinical predictors or treatment measures. Some medications and surgical procedures have shown certain efficacy in preventing and improving CNR after PCI, but the long-term cardiovascular benefits remain unknown. In this review, we focus on the definition and diagnosis, risk factors and predictors, and prevention and treatment measures, thus to improve clinical attention to CNR after PCI in STEMI patients and also to forecast future research directions.