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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

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Frequency and predictors of no-reflow phenomenon in patients with COVID-19 presenting with ST-segment elevation

Arda Güler1, İsmail Gürbak1, Cafer Panç1

  • 1Department of Cardiology, Health Sciences University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

Acta Cardiologica
|May 31, 2021
PubMed

Insights

In ST-elevation myocardial infarction (STEMI) patients with COVID-19, the no-reflow phenomenon was numerically higher. Neutrophil-lymphocyte ratio (NLR) and D-dimer levels independently predict no-reflow in these patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Hematology

Background:

  • Coronavirus disease-2019 (COVID-19) is associated with a pro-thrombotic state affecting both arterial and venous systems.
  • ST-elevation myocardial infarction (STEMI) in COVID-19 patients can lead to more severe outcomes due to increased thrombosis burden.

Purpose of the Study:

  • To determine the frequency of the no-reflow phenomenon in STEMI patients with COVID-19.
  • To identify predictors of no-reflow in COVID-19 patients experiencing STEMI.

Main Methods:

  • A retrospective, observational study of 126 STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
  • Patients were divided into COVID-19 positive (n=62) and COVID-19 negative (n=64) groups.
  • Comparison of clinical and laboratory parameters, including inflammatory markers and thrombotic markers.

Main Results:

  • COVID-19 positive patients showed significantly higher C-reactive protein, D-dimer, ferritin, and neutrophil-lymphocyte ratio (NLR), and lower lymphocyte counts.
  • The no-reflow phenomenon was numerically more frequent in the COVID-19 positive group.
  • Multivariable analysis identified D-dimer and NLR as independent predictors of no-reflow in COVID-19 patients.

Conclusions:

  • While no statistically significant difference in no-reflow frequency was observed between COVID-19 and non-COVID-19 STEMI patients, a trend towards higher incidence in COVID-19 patients was noted.
  • Neutrophil-lymphocyte ratio (NLR) and D-dimer are significant independent predictors for the development of no-reflow in STEMI patients with COVID-19.
Abstract

Keywords:
COVID-19ST-segment elevation myocardial infarctionno-reflow phenomenonprimary percutaneous coronary intervention

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