Author + information
- Batmyagmar Khuyag1,
- Surenjav Chimed2,
- Amarjargal Baldandorj3,
- Lkhagvasuren Zundui1 and
- Narantuya Davaakhuu1
No-reflow phenomenon is a condition which normal blood flow isn’t restored after relief of vessel obstruction. There are the considerable number of patients had coronary no-reflow phenomenon after primary PCI in patients with STEMI. In this study, we aimed to reveal whether coronary no-reflow phenomenon after primary PCI has prognostic information in patients with STEMI.
We prospectively included patients with STEMI who underwent primary PCI for reperfusion. Diagnosis of no-reflow was made by using angiographic criteria. The primary endpoint was 30-day mortality.
A total of 414 patients included (mean age 59 ± 13 years, 84% male) and a no-reflow phenomenon was diagnosed in 47 patients (11%). Patients with no-reflow phenomenon were older (68 ± 11 years vs. 59 ± 13 years, p<0.001), more likely had stable angina (10.6% vs. 2.5%, p<0.01), longer door-to-balloon time (75 min [IQR 41; 139] vs. 52 min [IQR 40; 73], p<0.01), lower LVEF (47 ± 14% vs. 53 ± 11%, p<0.001) and higher WMSI (1.67 ± 0.53 vs. 1.43 ± 0.46, p<0.001) compared with patients without no-reflow phenomenon. In stepwise multiple logistic regression analysis including age, diabetes, hypertension, known HF, CKD, stable angina, Killip class, troponin I level, multivessel disease, involvement of LAD, LVEF and WMSI revealed that no-reflow phenomenon after primary PCI was independently associated with 30-day mortality in patients with STEMI (OR=7.89, 95% CI 1.99-31.3, p=0.003).
In patients with STEMI who underwent primary PCI for reperfusion, a coronary no-reflow phenomenon is a strong and independent predictor of 30-day mortality.