Abstract
The no-reflow phenomenon (NR) following percutaneous coronary intervention (PCI) is an unpredictable complication linked to increased in-hospital mortality and adverse cardiovascular outcomes. Reliable predictors of NR remain unclear. This systematic review and meta-analysis aimed to evaluate the association between serum uric acid to albumin ratio (UAR) and NR development after PCI. A comprehensive search of MEDLINE, Cochrane, and EMBASE databases identified observational studies assessing this relationship. Studies that provided multivariate regression analyses to determine whether UAR is an independent predictor of NR were included, and pooled odds ratios (OR) were calculated using random effects models. Three studies with a total of 2,199 patients were included. The pooled analysis demonstrated a significant association between higher UAR and an increased risk of NR (OR: 3.04; 95% CI: 2.26-4.10; p < 0.00001; I² = 0%). These findings indicate that a higher serum UAR is independently associated with NR development and may serve as a useful, easily measurable predictor in clinical practice.