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Predicting no-reflow phenomenon prior to primary percutaneous coronary intervention using a novel probability risk

Z Stajic1, D Milicevic, S Kafedzic

  • 1Department of Cardiology, Clinical Hospital Center Zemun, Belgrade, Serbia. zoran0312@yahoo.com.

European Review for Medical and Pharmacological Sciences
|February 18, 2022
PubMed

Insights

A new risk score predicts no-reflow (NRF) phenomenon in ST-segment elevation myocardial infarction (STEMI) patients before primary percutaneous coronary intervention (PPCI). This tool uses five clinical and angiographic factors for accurate NRF prediction.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Risk Stratification

Background:

  • The no-reflow (NRF) phenomenon is a complication of primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) patients.
  • Predicting NRF before PPCI is crucial for optimizing patient management and outcomes.

Purpose of the Study:

  • To develop and validate a clinically applicable risk score for predicting the NRF phenomenon.
  • To identify independent predictors of NRF in STEMI patients undergoing PPCI.

Main Methods:

  • A retrospective analysis of 1254 STEMI patients undergoing PPCI was conducted.
  • Patients were divided into derivation (n=840) and validation (n=414) cohorts.
  • Univariate and multivariate regression analyses identified independent predictors, forming a risk score validated using ROC curves.

Main Results:

  • Five independent predictors of NRF were identified: age ≥ 65, heart rate ≥ 89 bpm, Killip class ≥ II, total ischemic time ≥ 268 min, and thrombus burden ≥ 4.
  • The developed risk score ranged from 0 to 17 points, with an optimal cutoff of 11 points.
  • The risk score demonstrated good discriminant power in both derivation (AUC: 0.772) and validation groups.

Conclusions:

  • A novel risk score integrating five clinical and angiographic parameters was developed.
  • This score serves as a potentially valuable tool for predicting NRF in STEMI patients before PPCI.
  • The risk score offers acceptable accuracy for clinical use in NRF prediction.
Abstract

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