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Outcomes in Coronary No-Reflow Phenomenon Patients and the Relationship between Kidney Injury Molecule-1 and Coronary
Mustafa Ahmet Huyut1, Aylin Hatice Yamac2
1Yeni Yuzyil University - Cardiology, Istanbul - Turquia.
Insights
Elevated serum Kidney Injury Molecule-1 (KIM-1) levels and lower heart rate (HR) are linked to coronary no-reflow phenomenon (CNP) in ST-segment elevation myocardial infarction (STEMI) patients. CNP also increases stroke risk.
Area of Science:
- Cardiology
- Biomarkers
- Acute Myocardial Infarction
Background:
- Coronary no-reflow phenomenon (CNP) is a complication of percutaneous coronary intervention.
- CNP is associated with adverse cardiovascular outcomes, including major adverse cardiovascular events (MACE).
Purpose of the Study:
- To investigate the association between serum Kidney Injury Molecule-1 (KIM-1) levels and CNP in patients with acute ST-segment elevation myocardial infarction (STEMI).
Main Methods:
- A total of 160 STEMI patients were divided into a reflow group (n=140) and a no-reflow group (n=20).
- Serum KIM-1 levels, body mass index (BMI), heart rate (HR), and EuroSCORE II were measured.
- Patients were followed for one year to assess outcomes, including stroke incidence.
Main Results:
- CNP occurred in 12.50% of STEMI patients.
- Serum KIM-1 levels were significantly higher in the no-reflow group compared to the reflow group (p<0.001).
- Lower HR (p<0.001), higher BMI (p=0.047), and higher EuroSCORE II (p=0.016) were also observed in the no-reflow group.
- Baseline KIM-1 levels and lower HR were identified as independent predictors of CNP (p=0.002 and p<0.001, respectively).
- The incidence of stroke was significantly higher in the no-reflow group (15% vs. 2.90%, p=0.013).
Conclusions:
- Baseline serum KIM-1 concentrations and lower heart rate are independently associated with CNP in STEMI patients.
- CNP in STEMI patients is linked to an increased incidence of stroke during a one-year follow-up.
Background:
Coronary no-reflow phenomenon (CNP) is associated with an increased risk of major cardiovascular adverse events (MACE).
Objective:
This study aimed to evaluate the relationship between serum Kidney Injury Molecule-1 (KIM-1) levels and CNP in patients with acute ST-segment elevation myocardial infarction (STEMI).
Methods:
This study included a total of 160 patients (113 males and 47 females; mean age: 61.65±12.14 years) who were diagnosed with STEMI. The patients were divided into two groups, the reflow group (RG) (n=140) and the no-reflow group (NRG) (n=20). Patients were followed during one year. A p-value of <0.05 was considered significant.
Results:
CNP was observed in 12.50% of the patients. Serum KIM-1 was significantly higher in the NRG than in the RG (20.26±7,32 vs. 13.45±6.40, p<0.001). Body mass index (BMI) was significantly higher in the NRG than in the RG (29.41 (28.48-31.23) vs. 27.56 (25.44-31.03), p=0.047). Heart rate (HR) was significantly lower in the NRG than in the RG (61.6±8.04 vs. 80.37±14.61, p<0.001). The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) was significantly higher in the NRG than in the RG (3.06±2.22 vs. 2.36±2.85, p=0.016). The incidence of stroke was significantly higher in the NRG than in the RG (15% vs. 2.90%, p=0.013). The baseline KIM-1 level (OR=1.19, 95% CI:1.07 to 1.34, p=0.002) and HR (OR=0.784, 95% CI:0.69 to 0.88, p<0.001) were the independent predictors of CNP.
Conclusion:
In conclusion, baseline serum KIM-1 concentrations and lower HR are independently associated with CNP in STEMI patients and the incidence of stroke was significantly higher in the NRG in the one-year follow-up. (Arq Bras Cardiol. 2021; 116(2):238-247).
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