Predictors of No-Reflow Phenomenon in Young Patients With Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Angiology. 2016 Aug;67(7):683-9. doi: 10.1177/0003319715605977. Epub 2015 Sep 13.

Abstract

No-reflow is of prognostic value in ST-segment elevation myocardial infarction (STEMI) but has not been extensively investigated in young patients. Young patients with STEMI admitted within 12 hours from symptom onset and treated by primary percutaneous coronary intervention (pPCI) were recruited. Patients were classified into 2 groups based on postintervention thrombolysis in myocardial infarction (TIMI) flow grade; no-reflow: TIMI flow grade 0, 1 or 2 (group 1; n = 27; 21 men, mean age: 42 ± 4 years); and angiographic success: TIMI flow grade 3 (group 2; n = 118; 110 men, mean age: 43 ± 4 years). Adjusted odds ratios were 13.79 for female gender (P < .001; confidence interval [CI] = 1.88-101.26), 2.09 for pain to balloon time (P < .017; CI = 1.14-3.812), 12.29 for high TIMI thrombus grade (P = .012; CI = 1.74-86.94), 0.04 for tirofiban use (P < .001; CI = 0.01-0.22), 5.19 for mean platelet volume (MPV; P < .001; CI = 2.44-11.01), and 1.008 for platelet-lymphocyte ratio (PLR; P = .034; CI = 1.001-1.016). In conclusion, female gender, pain to balloon time, high TIMI thrombus grade, tirofiban, MPV, and PLR were independent predictors of no-reflow in young patients with STEMI after pPCI.

Keywords: ST-segment elevation myocardial infarction; female gender; pain to balloon time; primary percutaneous coronary intervention; thrombus grade; young patients.

MeSH terms

  • Adult
  • Age Factors
  • Chi-Square Distribution
  • Coronary Circulation
  • Female
  • Humans
  • Logistic Models
  • Lymphocyte Count
  • Male
  • Mean Platelet Volume
  • Middle Aged
  • No-Reflow Phenomenon / blood
  • No-Reflow Phenomenon / diagnostic imaging
  • No-Reflow Phenomenon / etiology*
  • No-Reflow Phenomenon / physiopathology
  • Odds Ratio
  • Percutaneous Coronary Intervention / adverse effects*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Platelet Count
  • Retrospective Studies
  • Risk Factors
  • ST Elevation Myocardial Infarction / blood
  • ST Elevation Myocardial Infarction / diagnostic imaging
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / therapy*
  • Sex Factors
  • Time Factors
  • Time-to-Treatment
  • Tirofiban
  • Treatment Outcome
  • Tyrosine / analogs & derivatives
  • Tyrosine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Tyrosine
  • Tirofiban