Key result
Higher admission serum cystatin C levels were independently associated with an increased risk of the no-reflow phenomenon during primary percutaneous coronary intervention in STEMI patients (OR 10.07).
Why the study?
No-reflow is a serious and frequent event during PPCI for acute STEMI, motivating the identification of possible predictors.
Does elevated admission serum cystatin C predict the no-reflow phenomenon in patients with acute anterior STEMI undergoing primary percutaneous coronary intervention?
Observational (n=218)
No
Does elevated admission serum cystatin C predict the no-reflow phenomenon in patients with acute anterior STEMI undergoing primary percutaneous coronary intervention?
Admission serum cystatin C levels are independently associated with the no-reflow phenomenon in patients with acute anterior STEMI undergoing primary PCI, suggesting its potential utility as an early risk stratification marker.
BACKGROUND/AIM: No-reflow is a serious and frequent event during primary percutaneous coronary intervention (PPCI) for acute ST segment elevation myocardial infarction (STEMI). The aim of this study was to identify possible predictors for no-reflow. PATIENTS AND METHODS: We investigated 218 patients with acute anterior STEMI who underwent PPCI from December 2016 to December 2018. No-reflow was defined as a coronary TIMI flow grade of ≤ 2. TIMI flow grade 3 was defined as normal reflow. RESULTS: In our study, the no-reflow phenomenon was observed in 39 patients (18%) during angiography. The patients of no-reflow group were found to be more older, diabetics, longer pain-to-balloon time, lower blood pressure, higher platelet counts and higher levels of D-Dimer and Cystatin C (Cys-C). In multivariate logistic regression analysis, only diabetes (OR = 0.371, 95% CI: 0.157-0.872, P = 0.023), longer pain-to-balloon time (OR = 1.147, 95% CI: 1.015-1.297, P = 0.028) and higher Cys-C level (OR = 10.07, 95% CI: 2.340-43.377, P = 0.002) were predictors for no-reflow. CONCLUSION: Cys-C might be a useful predictor for the no-reflow phenomenon after PPCI in STEMI patients. It might help to screen STEMI patients with high risk of no-reflow on admission.
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Cheng et al. (2019) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=218). Serum cystatin C level vs. Lower serum cystatin C level was evaluated on No-reflow phenomenon (coronary TIMI flow grade ≤ 2) (OR 10.07, 95% CI 2.340-43.377, p=0.002). Higher admission serum cystatin C levels were independently associated with an increased risk of the no-reflow phenomenon during primary percutaneous coronary intervention in STEMI patients (OR 10.07).
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