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Many factors were studied in the literature to confirm that their presence can
predict the developments of the no reflow phenomenon, most important of
them include:
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The relevance of high thrombus burden at the site of the culprit artery
in predicting distal embolization has also been shown by (Limbruno et al.,
2005)
Pathogenetic
Mechanism of No- Therapeutic
Reflow Predictor Implications
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Reperfusion Neutrophil count Specific
antineutrophil drugs
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The extent of the ischemic region is another important determinant of
no-reflow, as demonstrated in animal models. This is confirmed in man by
the association of electrocardiographic (ECG) and echocardiographic
indexes of the extent of ischemic region, such as QRS score and wall motion
score index respectively, and prevalence of no-reflow. (Uyarel H et al.,
2006).
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Natural antioxidant levels might protect from no-reflow as
demonstrated when levels of vitamin C, vitamin E, and glutathione
peroxidase obtained from coronary sinus before PPCI were significantly
lower in patients exhibiting no-reflow than in patients exhibiting myocardial
reperfusion. (Matsumoto et al., 2004).
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