Key result
No-reflow during primary percutaneous coronary intervention was associated with significantly higher in-hospital mortality (7.9%) compared to normal flow (2.9%).
Why the study?
The study aimed to identify clinical, angiographic, and procedural predictors of the no-reflow phenomenon in patients with STEMI undergoing PPCI, and to determine its impact on in-hospital mortality.
Observational (n=410)
No
In patients with STEMI undergoing primary PCI, diabetes, prolonged ischemic time, high thrombus burden, and low LVEF independently predict no-reflow, which is associated with a more than twofold increase in in-hospital mortality.
No-reflow signals elevated in-hospital mortality risk in STEMI; hypothesis-generating for prevention trials before changing practice.
The no-reflow phenomenon occurs in a considerable number of patients with ST elevation myocardial infarction (STEMI) undergoing primary reperfusion therapy. Our study aimed to identify clinical, angiographic, and procedural variables that predict this phenomenon in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), as well as determine the impact of no-reflow on in-hospital mortality. Prospective observational data from 410 patients with STEMI undergoing PPCI were obtained. In this study, diabetes mellitus, late presentation, higher Killip class at admission, anterior wall infarction, proximal site of occlusion, presence of high-grade thrombus, and left ventricular systolic dysfunction at admission were significantly associated with suboptimal coronary flow. Diabetes mellitus, a high thrombus burden, prolonged total ischemic time, and low left ventricular ejection fraction on admission were independent predictors of no-reflow. No-reflow during PPCI was associated with in-hospital mortality more than twice that for normal flow.
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Rajesh et al. (2018) conducted an observational in ST elevation myocardial infarction (STEMI) (n=410). No-reflow vs. Normal flow was evaluated on In-hospital mortality (p=0.049). No-reflow during primary percutaneous coronary intervention was associated with significantly higher in-hospital mortality (7.9%) compared to normal flow (2.9%).
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