No-reflow reversibility: a study based on serial assessment of multiple biomarkers

No-reflow after primary percutaneous coronary intervention (pPCI) may be reversible. 40 patients undergoing pPCI were evaluated by assessing either improvement or lack of changes regarding angiographic and electrocardiographic indexes of no-reflow between admission and pre-discharge. Myeloperoxidase (MPO; in nanograms per milliliter), C-reactive protein (CRP; in milligrams per liter), endothelin-1 (ET-1; in nanograms per milliliter), angiopoietin-2 (Ang-2, in picograms per milliliter), and their pre-discharge/basal values variations (\u394) were related to no-reflow evolution. \u394MPO and \u394CRP were greater in patients with sustained no-reflow or lack of ST-segment resolution (STR) as compared with those with reversible no-reflow or lack of STR (p\u2009=\u20090.033, p\u2009=\u20090.04, p\u2009<\u20090.001, and p\u2009=\u20090.001, respectively), whereas \u394ET-1 was similar in the two groups. \u394Ang-2 was greater in patients with sustained no-reflow or lack of STR as compared with those with reversible no-reflow or lack of STR (p\u2009=\u20090.01 and 0.044, respectively). Bigger \u394MPO, \u394CRP (increasing levels), and \u394Ang-2 (decreasing levels) are associated with sustained no-reflow, thus they might have a role in no-reflow evolution