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2014, Number 5

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Rev Med Inst Mex Seguro Soc 2014; 52 (5)

Predictors of no-reflow phenomenon after primary percutaneous coronary intervention

Rivera-Linares BM, Bedolla-Barajas M, Morales-Romero J, Jiménez-Gómez JE

Language: Spanish
References: 24
Page: 522-529
PDF size: 218.04 Kb.


ABSTRACT

Background: No-reflow phenomenon is a common event in patients with acute myocardial infarction with ST elevation (STEMI) who underwent primary percutaneous coronary intervention. The objective is to determine the cumulative incidence of no-reflow phenomenon and some predictors related to its occurrence.
Methods: We retrospectively analyzed the reports of 71 patients with STEMI. Subjects were categorized in two groups, those with no-reflow phenomenon and those without it; their clinical findings were compared. Predictive factors were identified by logistic regression analysis.
Results: We identified 20 patients with no-reflow phenomenon (with a cumulative incidence of 28.1 %) and 51 with adequate reperfusion. In the univariate analysis the following predictors were related to the no-reflow phenomenon: CK-MB ≥ 160 UI/L, Killip class ≥ II, TIMI flow 0, having more than two Q waves in ECG, the form of reperfusion therapy and the presence of intracoronary thrombus. The multivariate logistic regression analysis identified Killip class ≥ II (OR = 9.3, p = 0.008), ≥ two Q waves in ECG (OR = 1.8, p = 0.05), angioplasty as unique reperfusion therapy (OR = 19.9, p = 0.017) and the presence of intracoronary thrombus (OR = 11.9, p = 0.008) as predictors of no-reflow phenomenon.
Conclusion: The early detection of predictors of no-reflow phenomenon will establish measures aimed to reduce its presentation.


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