Predictors in no-reflow phenomenon in acute myocardial infarction with ST-segment elevation
Jesús A Ruíz-Avalos1, Lisette Bazán-Rodríguez1, Gabriela Espinoza-Escobar1
1Departamento de Cardiología, Centro Médico Nacional del Noroeste, IMSS.
Insights
Predictive factors for the no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI) were identified. Baseline TIMI flow ≤ 2 and ER KDIGO ≥ 3 are significant predictors.
Area of Science:
- Cardiology
- Interventional Cardiology
- Acute Coronary Syndromes
Background:
- The no-reflow (NR) phenomenon is a significant complication following percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
- NR is associated with increased morbidity and mortality.
- Identifying predictors of NR is crucial for risk stratification and management.
Purpose of the Study:
- To identify independent predictive factors for the no-reflow phenomenon in STEMI patients treated with PCI.
- To improve risk assessment for NR before and during PCI procedures.
Main Methods:
- A cohort of 103 STEMI patients undergoing PCI was analyzed.
- Subjects were categorized based on the presence or absence of the NR phenomenon.
- Multivariate logistic regression analysis was employed to identify predictors, including clinical and laboratory parameters.
Main Results:
- Baseline Thrombolysis In Myocardial Infarction (TIMI) flow of ≤ 2 was a significant predictor of NR (OR 6.03; p=0.04).
- Elevated Enzymatic Rate (ER) KDIGO ≥ 3 was also identified as an independent predictor (OR 2.61; p=0.04).
Conclusions:
- The no-reflow phenomenon remains a critical challenge in STEMI management.
- Baseline TIMI flow and ER KDIGO are valuable factors for stratifying STEMI patients at risk of NR.
- These findings can guide pre-procedural risk assessment and intervention strategies.
Background:
No-reflow (NR) phenomenon is one of the most feared complications after percutaneous coronary intervention (PCI) in the treatment of ST-segment elevation myocardial infarction (STEMI) due to its high morbidity and mortality.
Objective:
To describe the predictive factors for NR phenomenon in a group of subjects with STEMI treated with PCI.
Method:
One hundred and three cases of STEMI who underwent PCI. The subjects were divided according to the presence of NR phenomenon. In a multivariate analysis age, gender, comorbidities, weight, and other clinical and laboratory parameters were studied as predictors of NR phenomenon were studied.
Results:
In this study, logistic regression analysis identified as independent factors for the development of NR phenomenon baseline TIMI flow ≤ 2 (OR 6.03; 95% CI, 0.9 to 11.8; p = 0.04), ER KDIGO ≥ 3 (OR OR 2.61; 95% CI, 1.0 to 2.4; p = 0.04).
Conclusions:
NR phenomenon continues to be a challenge for short and long-term morbidity and mortality in STEMI. The identified factors can be used for the stratification of cases with STEMI and risk of NR phenomenon prior to PCI.
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