Study on the relationship between serological markers and slow flow/no-reflow after emergency percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction

He Jie; Qiu Shixiang; Pu Jiaqi; Wang Hong

doi:10.3760/j.issn.1673-4777.2026.05.003

Abstract：Objective To investigate the relationship between soluble intercellular adhesion molecule-1(sICAM-1),low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(LDL-C/HDL-C)and slow flow/no-reflow after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A prospective study was performed on 286 patients with acute STEMI admitted to Department of Emergency,Nanchong Central Hospital from January 2022 to January 2025.Patients with thrombolysis in myocardial infarction(TIMI)flow grade ≤ 2 after operation were assigned to the abnormal blood flow group,and those with TIMI grade 3 to the normal blood flow group.Clinical and laboratory data were compared between the two groups.Logistic regression analysis was used to identify risk factors for slow flow/no-reflow after PCI.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum sICAM-1 and LDL-C/HDL-C for slow flow/no-reflow.Results Among the 286 patients,231 were in the normal blood flow group and 55 in the abnormal blood flow group.The time from symptom onset to PCI was longer,and white blood cell count and neutrophil count were higher in the abnormal blood flow group than those in the normal blood flow group(all P＜0.05).Serum levels of sICAM-1 and LDL-C/HDL-C were significantly higher in the abnormal blood flow group than those in the normal blood flow group[(410±55)μg/L vs(361±49)μg/L,(2.9±0.8)vs(2.3±0.6)](t=6.583,5.526,both P＜0.001).Logistic regression analysis showed that elevated sICAM-1,LDL-C/HDL-C,time from onset to PCI,white blood cell count and neutrophil count were independent risk factors for slow flow/no-reflow after PCI(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of sICAM-1,LDL-C/HDL-C alone and in combination was 0.769,0.763 and 0.868,respectively.The AUC of the combined detection was significantly higher than that of single detection(Z=2.528,P=0.012;Z=2.926,P=0.003).Conclusion Abnormally elevated serum sICAM-1 and LDL-C/HDL-C are independent risk factors for slow flow/no-reflow in STEMI patients after PCI,and their combination has high predictive efficiency for slow flow/no-reflow.