Key result
Advanced age > 75 years (OR 6.02), tachycardia (OR 4.3), delay to angioplasty > 6 hours (OR 1.3), and high thrombotic load (OR 1.5) were independent predictors of no reflow during primary angioplasty.
Why the study?
No reflow during primary angioplasty is associated with a poor prognosis despite reopening of the culprit coronary, motivating the identification of its predictive factors.
Observational (n=354)
No
Advanced age, tachycardia, delayed reperfusion (>6 hours), and high thrombotic load are independent predictors of angiographic no reflow during primary angioplasty for STEMI.
May flag high-risk STEMI patients for no-reflow during primary PCI; hypothesis-generating and leaves open prospective validation.
Introduction: No reflow during primary angioplasty is associated with a poor prognosis despite the reopening of the culprit coronary. The aim of our work was to determine the predictive factors of no reflow. Methodology: Single-center retrospective analytical study from June 2000 to December 2016 that included patients presenting with STEMI took care of by primary angioplasty. No reflow was defined according to angiographic criteria: a TIMI flow Results: The prevalence of no reflow was 24%. In univariate analysis mean age, diabetes,hypertension, tachycardia, hypotension, killip stage 4 left ventricular failure, hyperglycemia > 11, renal failure, left ventricular dysfunction, tritruncal status, common trunk involvement, initial TIMI flow at 0, significant thrombotic load, delay to angioplasty > 6 hours, and predilation were all correlated with no reflow with a p 75 years [OR = 6.02, 95% CI 1.4 - 27, p = 0.014], tachycardia [OR = 4.3, 95% CI 1.6 - 7.4, p = 0.037], delay to angioplasty > 6 hours [OR = 1.3, 95% CI 1.1 - 2.1, p = 0.003] and high thrombotic load [OR = 1.5, 95% CI 1.3 - 3.2, p = 0.02] were independent predictors of no reflow. Conclusion: No reflow is associated with a poor short-term prognosis. Its care requires knowledge of predictive factors, prevention and treatment.
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Kpelafia et al. (2023) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=354). Age > 75 years vs. Age ≤ 75 years was evaluated on Angiographic no reflow (TIMI flow < 3 or TIMI 3 with MBG ≤ 1) (OR 6.02, 95% CI 1.4-27, p=0.014). Advanced age > 75 years (OR 6.02), tachycardia (OR 4.3), delay to angioplasty > 6 hours (OR 1.3), and high thrombotic load (OR 1.5) were independent predictors of no reflow during primary angioplasty.
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