The Predictors of No-Reflow Phenomenon after Primary Angioplasty for Acute Myocardial Infarction

authors:

avatar Ata Firouzi 1 , * , avatar Kamran Aeinfar 2 , avatar Hossein Shahsavari 2 , avatar Hamidreza Sanati 1 , avatar Farshad Shakerian 1 , avatar Reza Kiani 1 , avatar Ali Zahed Mehr 1

Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
International Cardiovascular Research Journal: Vol.10, issue 3; e10162
published online: September 15, 2016
article type: Review Article
received: July 11, 2015
revised: January 05, 2016
accepted: January 11, 2016

how to cite: Firouzi A , Aeinfar K, Shahsavari H , Sanati H , Shakerian F , et al. The Predictors of No-Reflow Phenomenon after Primary Angioplasty for Acute Myocardial Infarction. Int Cardiovasc Res J. 2016;10(3):e10162. 

Abstract

Background:
No-reflow phenomenon is a serious complication of primary Percutaneous Coronary Intervention (PCI), which may increase the risk of progressive myocardial damage, profound left ventricular dysfunction, and death.
Objectives:
This study aimed to investigate the incidence of no-reflow phenomenon and its clinical, para-clinical, and angiographic determinants in patients who underwent primary PCI for ST Elevation Myocardial Infarction (STEMI).
Patients and Methods:
This non-randomized prospective cohort study was conducted on 397 patients in a cardiovascular tertiary care center in Tehran, Iran from April 2012 to April 2014. The inclusion criteria of the study were presenting with acute STEMI of ≤ 12 h duration or having admitted between 12 and 24 hours after onset with symptoms and signs of ongoing ischemia. The participants underwent standard coronary angiography. No-reflow phenomenon was defined as a Thrombolysis In Myocardial Infarction (TIMI) flow ≤ 2 and no presence of spasm, distal embolization, or dissection after completion of the procedure. The association between no-reflow and its determinants was assessed by chi-square, student’s t-test, or Mann–Whitney U test. Logistic regression models were also used for multivariate analysis. P values < 0.05 were considered to be statistically significant.
Results:
The participants’ mean (SD) age was of 59 (12.2) years and female/male ratio was 83/314. The incidence of no-reflow phenomenon was 63 (15.9%). Besides, the results of multivariate analysis showed that only thrombus burden, lesion length, time to reperfusion, and type of occlusion had an adjusted association with this phenomenon. 
Conclusions:
The study results suggested that no-reflow phenomenon after primary PCI would be predictable. Thus, preventive measures, such as using distal protective devices or administration of platelet glycoprotein IIb/IIIa antagonists, are advised to be used in high-risk patients.
 

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References

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