Key result
Age over 62 and elevated creatinine independently predict no-reflow risk after primary PCI for STEMI.
Why the study?
The coronary no-reflow phenomenon after primary PCI in STEMI patients significantly worsens outcomes, but its predictability by demographic and routine laboratory factors remains unclear.
Cross-Sectional (n=306)
No
May identify higher no-reflow risk in STEMI; hypothesis-generating and requires prospective validation before clinical use.
BACKGROUND: The coronary no-reflow phenomenon is an adverse complication of percutaneous coronary interventions (PCI) which significantly worsens the outcome and survival. In this study, we have evaluated the correlation of no-reflow phenomenon with demographic, biochemical and anatomical factors. METHODS: We included 306 patients (193 male) with acute ST-elevation myocardial infarction (STEMI) who undergone primary PCI in our center. Demographic factors, as well as biochemistry test results were obtained. Also, the Thrombolysis in Myocardial Infarction (TIMI) grade and TIMI frame count (TFC) was measured. The correlation of no-reflow phenomenon with demographic, biochemical and anatomical factors was analyzed. RESULTS: Patients with a mean age of 56.41 ± 11.8 years were divided into two groups depending on the TIMI score (Group 1 or Normal flow and Group 2 or No-reflow). Symptom-to-procedure time, door-to-procedure time, serum creatinine level, hs-CRP level, and Neutrophil to Lymphocyte Ratio (NLR) were significantly higher among group 2. TFC had negative significant correlation with male gender, and positive significant correlation with age, diabetes mellitus, hs-CRP level, WBC count, and NLR. Age of more than 62.5 years and serum creatinine level of more than 0.89 mg/dL can optimally predict the no reflow phenomena. CONCLUSIONS: According to our results, it seems that female gender, older ages, DM, multi-vessel involvement, delayed reperfusion, and increased NLR can predict the risk of no-reflow after primary PCI in the setting of Acute Myocardial Infarction.
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Namazi et al. (2021) conducted a cross-sectional in Acute ST-elevation myocardial infarction (STEMI) (n=306). Demographic, biochemical, and anatomical risk factors (e.g., age >62.5 years, serum creatinine >0.89 mg/dL) vs. Absence of risk factors was evaluated on Prediction of no-reflow phenomenon (TIMI score 0-2) by age > 62.5 years (AUC 0.636, 95% CI 0.621-0.650, p=<0.001). Age greater than 62.5 years (AUC 0.636) and serum creatinine higher than 0.89 mg/dL (AUC 0.639) optimally predicted the development of the no-reflow phenomenon in patients with STEMI undergoing primary PCI.
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