Risk factors of no-reflow phenomenon after primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction
Li Yong
Abstract：Objective To analyze risk factors of no-reflow phenomenon in patients with acute ST-elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention (PPCI).Methods Totally 332 STEMI patients who had PPCI from January 2007 to January 2010 in Beijing Anzhen Hospital,Capital Medical University were divided into 2 groups according to thrombolysis in myocardial infarction(TIMI) coronary flow grade after PPCI:no-reflow group(30 cases,TIMI grade 0-2) and control group(302 cases,TIMI grade 3).Totally 39clinical items were recorded,including age,sex,angina history,myocardial infarction history,hypertension history,diabetes history,smoking history,PCI history,β-receptor antagonist usage,myocardial infarction site,single vessel/multiple vessels lesion,culprit vessel site,culprit vessel occlusion degree,occurrences of preoperative primary ventricular fibrillation,intraoperative ventricular fibrillation,preoperative ventricular tachycardia,intraoperative ventricular tachycardia,preoperative bradycardia,introperative bradycardia,introperative hypotension,the usage of thrombus suction device during operation,the usage of intra-aortic balloon counterpulsation during operation,the usage of temporary pacemaker during operation,the length between myocardial infarction and PPCI,ejection fraction,high-density lipoprotein,low-density lipoprotein,triacylglycerol,cholesterol,glycosylated hemoglobin,fibrinogen,urea,uric acid,creatinine,blood potassium,blood glucose,white blood cell count,neutrophil percentage and hemoglobin level.Multivariate logistic regression was used to analyze risk factors of no-reflow phenomenon after PPCI.Results In present study,the incidence of no-reflow phenomenon was 9.0％(30/332).Age,the ratio of culprit vessel total occlusion,the ratio of introperative bradycardia,high density lipoprotein level,fibrinogen level and neutrophil percentage had significant differences between no-reflow group and control group[(61 ± 11) years vs (57 ± 11) years,83.3％ (25/30) vs 62.9％ (190/302),46.7％ (14/30) vs 25.8％(78/302),(0.98 ± 0.18) mmol/L vs (1.05 ±0.27)mmol/L,(2.8±0.9)g/L vs (2.5±0.7)g/L,(78 ± 14) ％ vs (73 ± 15) ％] (P ＜ 0.10).Multivariate logistic stepwise regression showed that intraoperative bradycardia(odd ratio =3.392,95％ confidence interval:1.427-8.062,P =0.006) and high fibrinogen level (odd ratio =2.017,95％ confidence interval:1.167-3.487,P =0.012) were independent risk factors of no-reflow phenomenon after PPCI.Conclusion Intraoperative bradvcardia and high fibrinogen level are independent risk factors of no-reflow phenomenon after PPCI in acute STEMI patients.
Keywords：Myocardial infarctionCoronary artery diseaseNo-reflow phenomenonBradycardiaFibrinogenRisk factors
Publication Date：2016-09-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1269-1273 )