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Evaluation of Hematological and Biochemical Parameters that Predict the No-reflow Phenomenon in Patients Undergoing
Selim Aydemir1, Sidar Şiyar Aydın2, Onur Altınkaya1
1Department of Cardiology, Erzurum City Hospital, University of Health Sciences, Erzurum, Turkey.
Insights
Predicting the no-reflow phenomenon (NRP) after primary percutaneous coronary intervention (pPCI) in acute coronary syndromes (ACS) is crucial. Routine blood tests like hemoglobin and white blood cell count can help identify patients at risk before treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Biochemistry
Background:
- Acute coronary syndromes (ACS) are a leading cause of death globally.
- Primary percutaneous coronary intervention (pPCI) is standard treatment for ACS to restore blood flow.
- The no-reflow phenomenon (NRP) can impede successful reperfusion despite pPCI.
Purpose of the Study:
- To identify and compare parameters that predict the occurrence of NRP in ACS patients undergoing pPCI.
- To evaluate the predictive value of common hematological and biochemical markers for NRP.
Main Methods:
- Retrospective analysis of 5122 ACS patients.
- Cox regression and Receiver Operating Characteristic (ROC) curve analysis were used.
- Identified independent predictors of NRP.
Main Results:
- NRP occurred in 1.8% of patients.
- Age, hemoglobin (Hb), white blood cell (WBC) count, glucose, and low-density lipoprotein cholesterol (LDL-C) were independent predictors of NRP.
- WBC count demonstrated the highest predictive power (AUC: 0.605).
Conclusions:
- Simple, routinely measured hematological and biochemical parameters can predict NRP risk in ACS patients before pPCI.
- Early identification of NRP risk can potentially improve patient management and outcomes.
Abstract:
Acute coronary syndromes (ACS) are one of the most common causes of morbidity and mortality worldwide. Primary percutaneous coronary intervention (pPCI) is the main treatment strategy to restore myocardial perfusion. However, the no-reflow phenomenon (NRP) may block coronary flow. The present study focused on assessing and contrasting predictive parameters for NRP in ACS patients. Our research is a retrospective analysis. We assessed the parameters significantly associated with NRP using Cox regression and Receiver operating characteristic (ROC) Curve analysis. The study included 5122 patients who met the criteria. The average age of the patients was 63.9 + 13.2, and 74.4% were male. It was observed that NRP developed in 1.8% of all patients. Age, hemoglobin (Hb), white blood cell (WBC), glucose and low density lipoprotein cholesterol (LDL-C) were determined to be independent predictors of NRP. The power of these parameters to predict NRP was similar, and WBC was the most predictive (Area Under Curve (AUC): 0.605 95% CI: 0.539-0.671, P = .001). We believe that the use of these simple, practical, and routinely used hematological and biochemical parameters will help us predict the risk of developing NRP before pPCI. This information should improve management.
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