The Association of Peak Glycemia and No-Reflow Phenomenon in Patients Undergoing Primary Percutaneous Coronary Intervention Publisher



Ghaffari G ; Mehrpooya M ; Faghihinia M ; Shahmohamadi E ; Larti F ; Geraiely B
Source: Cardiology Research and Practice Published:2026

Abstract

Objective: This study investigates the effect of peak glycemia on the no-reflow phenomenon in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) to examine the relationship between elevated blood glucose (BG) levels and no-reflow. Method: A total of 252 STEMI patients (81.7% male) who underwent PPCI were enrolled. BG was measured by a glucometer every 6 h for 24 h, starting at the time of patient admission. The maximum measured BG was considered the peak glycemic level. A corrected TIMI frame count (CTFC) of less than 27 was used to define the no-reflow phenomenon in this study. Results: 42.4% of participants experienced no flow, with a significant association between this condition and diabetes mellitus, peak glycemia, smoking history, and elevated LDL cholesterol levels. Specifically, peak glycemia levels above 180 mg/dL independently increased the odds of no-reflow occurrence (OR = 8.16, 95% CI = 4.1–16.2, p < 0.001). Conclusion: The importance of monitoring BG levels in STEMI patients, as well as the critical role of a multidisciplinary approach, regardless of diabetic status, in mitigating the risk of no-reflow and improving clinical outcomes, should be highlighted. Copyright © 2026 Golrokh Ghaffari et al. Cardiology Research and Practice published by John Wiley & Sons Ltd.