{"id":5424,"date":"2026-03-13T13:18:10","date_gmt":"2026-03-13T11:18:10","guid":{"rendered":"https:\/\/cvja.co.za\/journal\/?p=5424"},"modified":"2026-03-13T13:18:10","modified_gmt":"2026-03-13T11:18:10","slug":"cvja-2025-101","status":"publish","type":"post","link":"https:\/\/cvja.co.za\/journal\/cvja-2025-101\/","title":{"rendered":"Predictive Value of the Endothelial Activation and Stress Index for No-Reflow in NSTEMI Patients Undergoing Percutaneous Coronary Intervention"},"content":{"rendered":"
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\r\n \r\n \r\nMuhammet Cihat \u00c7elik, Macit Kal\u00e7\u0131k, Abdullah Sar\u0131han, Orhan Karayi\u011fit, M\u00fccahit Yetim, L\u00fctf\u00fc Bekar, Ya\u011fmur Ceren Do\u011fru Y\u0131lmaz, Yusuf Karavelio\u011flu\r\n<\/div> \r\n<\/div> \r\n
\r\n Copyright:<\/strong> Clinics Cardive Publishing (Pty) Ltd. publisher\r\n of Cardiovascular Journal of Africa.<\/div>\r\n
<\/div> \r\n
\r\n
\r\n Abstract \r\n <\/div> \r\n \r\n
\r\n \r\n \r\n \r\n \r\n\r\n Background:<\/strong> \r\n \r\nThe no-reflow phenomenon, defined as inadequate myocardial perfusion despite successful epicardial recanalisation, remains a major complication after PCI in NSTEMI. Endothelial dysfunction and microvascular injury are key mechanisms. The Endothelial Activation and Stress Index (EASIX), calculated as (LDH \u00d7 creatinine) \/ platelet count, reflects systemic endothelial stress and may predict no-reflow.\r\n
\r\n\r\n Methods:<\/strong> \r\n \r\nThis retrospective, single-centre study included 543 NSTEMI patients who underwent urgent or early PCI between 2022 and 2024. Patients were divided into no-reflow (TIMI \u2264 2) and normal flow (TIMI 3) groups. Logistic regression identified independent predictors; ROC analysis assessed predictive accuracy.\r\n
\r\n \r\n Results:<\/strong> \r\nNo-reflow occurred in 72 patients (13.3%). These patients had higher EASIX, glucose, creatinine, LDH, and hs-CRP levels, and lower LVEF. Multivariate analysis showed that elevated EASIX (OR 2.155, 95% CI 1.211\u20133.835, p = 0.009), reduced LVEF (OR 0.900, 95% CI 0.868\u20130.933, p < 0.001), and LAD involvement (OR 1.854, 95% CI 1.113\u20134.717, p = 0.013) independently predicted no-reflow.\r\n
\r\n \r\n \r\n Conclusion:<\/strong> \r\n \r\nElevated EASIX, reduced LVEF, and LAD culprit lesion independently predict no-reflow in NSTEMI patients after PCI. EASIX, derived from routine tests, offers a simple and cost-effective tool for early identification of patients at high risk of microvascular obstruction.\r\n
\r\n \r\n\r\n \r\n <\/div> \r\n <\/div> \r\n \r\n \r\n
\r\n \r\n Keywords:<\/strong> \r\n \r\n Non-ST-segment elevation myocardial infarction, No-reflow, Endothelial Activation and Stress Index (EASIX), Percutaneous coronary intervention, Microvascular dysfunction<\/strong> \r\n \r\n <\/div> \r\n \r\n
\r\n \r\n Submitted:<\/strong> October 23, 2025; \r\n Accepted:<\/strong> November 17, 2025; \r\n Published:<\/strong> March 13, 2026
\r\n Cardiovasc J Afr 2025; 37<\/b>: 80-85<\/em>\r\n
Volume 37, Issue 1<\/strong>
\r\n <\/div> \r\n \r\n
\r\n DOI Citation Reference: dx.doi.org\/10.5830\/CVJA-2025-101 \r\n <\/div> \r\n \r\n
\r\n\r\n\r\nDepartment of Cardiology, Hitit University Erol Ol\u00e7ok Education and Research Hospital, Corum, Turkey\r\n<\/strong>
\r\nMuhammet Cihat \u00c7elik
\r\nAbdullah Sar\u0131han
\r\nYa\u011fmur Ceren Do\u011fru Y\u0131lmaz
\r\nYusuf Karavelio\u011flu\r\n\r\n

\r\n\r\nDepartment of Cardiology, Faculty of Medicine, Hitit University, Corum, Turkey\r\n<\/strong>
\r\nMacit Kal\u00e7\u0131k
\r\nM\u00fccahit Yetim
\r\nL\u00fctf\u00fc Bekar\r\n\r\n

\r\n\r\nDepartment of Cardiology, Yozgat City Hospital, Yozgat, Turkey\r\n<\/strong>
\r\nOrhan Karayi\u011fit\r\n\r\n

\r\n \r\n\r\n [soshsc hide=\"logged\"]\r\n You need to be logged in to view and download<\/a> the full text PDF version. Register for a free account?<\/a><\/strong>

[\/soshsc]\r\n \r\n \r\n \r\n <\/div>\r\n \r\n<\/div>","protected":false},"excerpt":{"rendered":"

The no-reflow phenomenon, defined as inadequate myocardial perfusion despite successful epicardial recanalisation, remains a major complication after PCI in NSTEMI. Endothelial dysfunction and microvascular injury are key mechanisms. The Endothelial Activation and Stress Index (EASIX), calculated as (LDH \u00d7 creatinine) \/ platelet count, reflects systemic endothelial stress and may predict no-reflow.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[44,109],"tags":[],"class_list":["post-5424","post","type-post","status-publish","format-standard","hentry","category-cardiovascular-topics","category-volume-37-issue-1"],"yoast_head":"\nPredictive Value of the Endothelial Activation and Stress Index for No-Reflow in NSTEMI Patients Undergoing Percutaneous Coronary Intervention - Cardiovascular Journal of Africa<\/title>\n<meta name=\"description\" content=\"The no-reflow phenomenon, defined as inadequate myocardial perfusion despite successful epicardial recanalisation, remains a major complication after PCI in NSTEMI. 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