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<head>
<doi_batch_id>_1781335226</doi_batch_id>
<timestamp>1781335226</timestamp>
<depositor>
<depositor_name>Ahmad Noeman</depositor_name>
<email_address>picjcvd@gmail.com</email_address>
</depositor>
<registrant>Punjab Institute of Cardiology, Lahore</registrant>
</head>
<body>
<journal>
<journal_metadata>
<full_title>The Journal of Cardiovascular Diseases</full_title>
<abbrev_title>J Cardiovasc Dis</abbrev_title>
<issn media_type="electronic">2309-9739</issn>
<issn media_type="print">2309-3544</issn>
</journal_metadata>
<journal_issue>
<publication_date media_type="online">
<month>02</month>
<day>27</day>
<year>2026</year>
</publication_date>
<journal_volume>
<volume>21</volume>
</journal_volume>
<issue>3</issue>
</journal_issue>
<journal_article xmlns:jats="http://www.ncbi.nlm.nih.gov/JATS1" publication_type="full_text" metadata_distribution_opts="any">
<titles>
<title>Kidney Dysfunction and the Risk of Slow-Flow / No-Reflow During Primary PCI for Acute Myocardial Infarction</title>
</titles>
<contributors>
<person_name contributor_role="author" sequence="first" language="en">
<given_name>Masood Ali Akbar</given_name>
<surname/>
</person_name>
<person_name contributor_role="author" sequence="additional" language="en">
<given_name>Kashif Zafar</given_name>
<surname/>
</person_name>
<person_name contributor_role="author" sequence="additional" language="en">
<given_name>Mohsin Asgher</given_name>
<surname/>
</person_name>
<person_name contributor_role="author" sequence="additional" language="en">
<given_name>Salman Munir</given_name>
<surname/>
</person_name>
<person_name contributor_role="author" sequence="additional" language="en">
<given_name>Atif Imran</given_name>
<surname/>
</person_name>
<person_name contributor_role="author" sequence="additional" language="en">
<given_name>Hamid Khalil</given_name>
<surname/>
</person_name>
</contributors>
<jats:abstract xmlns:jats="http://www.ncbi.nlm.nih.gov/JATS1">
<jats:p>Background:
Primary percutaneous coronary intervention (pPCI) is considered the gold standard treatment for patients with acute ST-elevation myocardial infarction (STEMI), as it significantly lowers both short and long-term mortality. This procedure successfully restores normal blood flow (TIMI-3 flow) in the infarct-related artery (IRA). Compromised kidney function is a recognized predictor of increased mortality and complications in STEMI patients undergoing primary PCI (pPCI). This adverse prognostic effect can appear even with a mild reduction in renal function. Several studies have also identified impaired kidney function as an independent risk factor for the development of the slow-flow or no-reflow (SF/NR) phenomenon.
Objective: To see the association of kidney dysfunction with patients having slow-flow/no- reflow phenomenon in STEMI patients undergoing pPCI and to evaluate its prognostic effect on short-term mortality in our local population
Material and Methods: The prospective observational study was conducted from 20-01-2025 to 15-05-2025 at the Cardiology Department, PIC Lahore. Patients of both genders age ranging from 18-75 years were enrolled to investigate the association between estimated glomerular filtration rate (eGFR) or serum creatinine and the incidence of SF/NR who were undergoing pPCI.
Results: Total enrollment of 227 patients having mean age 56.1 years, 154(68.0%) males and 73(32.0%) females, in which 16(7.0%) developed slow-flow/no-reflow post-PCI. Duration of pain, A.Fib, complete heart block, and heart failure have statistically significant differences as p- value < 0.05 and poorer baseline renal function, as evidenced by a lower eGFR (76.5±5.4 vs. 89.6±1.0 mL/min/1.73m², p=0.001). Angiographically, the no-reflow group had higher rates of pre- procedural total occlusion (TIMI 0 flow) and lower stent implantation rates. Mortality 1(6.3%) observed in slow / no-flow group with an insignificant p-value 0.141. Increasing age is an independent predictor, with each additional year raising the odds of slow/no-flow by about 4%. Hypertension doubled the likelihood of developing no-reflow p-value 0.020.
Conclusion: Impaired renal function significantly predicts slow-flow/no-reflow following primary PCI, underscoring the need for renal-based risk stratification before intervention
</jats:p>
</jats:abstract>
<publication_date media_type="online">
<month>03</month>
<day>02</day>
<year>2026</year>
</publication_date>
<doi_data>
<doi>10.55958/jcvd.v21i3.282</doi>
<resource>https://jcvdcme.com/index.php/Journal/article/view/282</resource>
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</journal_article>
</journal>
</body>
</doi_batch>