Author + information
- Durmuş Yıldıray Şahin1,
- Mustafa Gür1,
- Zafer Elbasan1,
- Osman Kuloğlu1,
- Taner Şeker1,
- Ali Kıvrak1,
- İbrahim Halil Tanboğa3,
- Gökhan Gözübüyük1,
- Sinan Kırım2 and
- Murat Çaylı1
The no-reflow phenomenon has a negative prognostic value in patients with acute ST elevation myocardial infarction (STEMI). SYNTAX score (SS) quantifies extent and complexity of angiographic disease and predict long-term mortality and morbidity in STEMI. We aimed to assess the no-reflow and its possible relationships with SS and clinical characteristics in patients with STEMI treated with primary percutaneous coronary intervention (PPCI).
In this study, 880 STEMI patients with STEMI treated with PPCI were prospectively included (646 male, 234 female; mean age 58.5±12.4 years). The SS, Thrombolysis in Myocardial Infarction (TIMI) flow grade score and TIMI myocardial blush grade (MBG) score were determined in all patients. No-reflow was defined as TIMI grade 0, 1 and 2 flows or TIMI grade 3 with MBG 0 and 1. The patients were divided into two groups as normal flow group and no-reflow group.
No-reflow was observed at 32.8% of patients. The mean SS of no-reflow group was higher than normal flow group (19.2±6.8/12.9±6.1, p<0.001). On multivariate logistic regression analysis, SS (β=0.872, %CI=0.845-0.899, p<0.001), diabetes (β=0.767, %CI=0.128-4.597, p=0.004), anterior myocardial infarction (β=5.421, %CI=1.369-21.469, p=0.025) and thrombus grade after wiring (β=2.537, %CI=1.506-4.273, p<0.001) were independent predictors of no-reflow. The cutoff value of SS obtained by the ROC curve analysis was 19.75 for the prediction of no-reflow (sensitivity: 70.6%, specificity: 69.4%).
The SS is a predictor of no-reflow in patients with STEMI treated with PPCI.
|Variables||Normal flow (n=591)||No-reflow (n=289)||p value|
|Age, years||56.3±12.2||61.8±11.7||< 0.001|
|Ejection fraction (%)||46.7±9.5||43.1±9.1||<0.001|