PMID- 33714407
OWN - NLM
STAT- MEDLINE
DCOM- 20210727
LR  - 20210727
IS  - 2213-3763 (Electronic)
IS  - 0019-4832 (Print)
IS  - 0019-4832 (Linking)
VI  - 73
IP  - 1
DP  - 2021 Jan-Feb
TI  - Novel predictors and adverse long-term outcomes of No-reflow phenomenon in 
      patients with acute ST elevation myocardial infarction undergoing primary 
      percutaneous coronary intervention.
PG  - 35-43
LID - S0019-4832(20)30458-2 [pii]
LID - 10.1016/j.ihj.2020.12.008 [doi]
AB  - OBJECTIVES: The no-reflow phenomenon occurs in 25% of patients with ST elevation 
      myocardial infarction (STEMI) undergoing primary percutaneous coronary 
      intervention (PCI), and may be associated with adverse outcomes. The aim of our 
      study was to detect novel predictors of no-reflow phenomenon and the resulting 
      adverse long term outcomes. METHODS: We enrolled 400 STEMI patients undergoing 
      primary PCI; 228 patients had TIMI flow 3 after PCI (57%) and the remaining 172 
      patients had TIMI flow <3 (43%). Fibrinogen to albumin ratio (FAR), high 
      sensitive C-reactive protein to albumin ratio (CAR), and atherogenic index of 
      plasma (AIP) were calculated. Long term mortality and morbidity during 6 months 
      follow up were recorded. These data were compared among both groups. RESULTS: In 
      multivariate regression analysis, old age (OR = 1.115, 95% CI: 1.032-1.205, 
      P = 0.006), higher troponin level >5.6 ng/mL (OR = 1.040, 95% CI: 1.001-1.080, 
      P = 0.04), diabetes mellitus (OR = 4.401, 95% CI: 1.081-17.923, P = 0.04) and 
      heavy thrombus burden (OR = 16.915, 95% CI: 5.055-56.602, P < 0.001) could be 
      considered as predictors for the development of no-reflow. Interestingly, CAR 
      >0.21, FAR >11.56, and AIP >0.52 could be considered as novel powerful 
      independent predictors (OR = 3.357, 95% CI: 2.288-4.927, P < 0.001, OR = 4.187, 
      95% CI: 2.761-6.349, P < 0.001, OR = 16.794, 95% CI: 1.018-277.01, P = 0.04, 
      respectively). Higher long term mortality (P < 0.001) and heart failure 
      (P < 0.001) was also strongly related to incidence of no-reflow. CONCLUSION: 
      No-reflow could be attributed to novel predictors as CAR, FAR, and AIP. This 
      phenomenon was associated with long term adverse events as higher mortality and 
      pump failure.
CI  - Copyright (c) 2020 Cardiological Society of India. Published by Elsevier B.V. All 
      rights reserved.
FAU - Refaat, Hesham
AU  - Refaat H
AD  - Cardiology Department, Zagazig University, Zagazig, Egypt. Electronic address: 
      heshamrefat22@yahoo.com.
FAU - Tantawy, Ayman
AU  - Tantawy A
AD  - Cardiology Department, Zagazig University, Zagazig, Egypt.
FAU - Gamal, Amr S
AU  - Gamal AS
AD  - Cardiology Department, Zagazig University, Zagazig, Egypt.
FAU - Radwan, Hanan
AU  - Radwan H
AD  - Cardiology Department, Zagazig University, Zagazig, Egypt.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20201229
PL  - India
TA  - Indian Heart J
JT  - Indian heart journal
JID - 0374675
SB  - IM
MH  - Aged
MH  - Coronary Angiography
MH  - Coronary Circulation/*physiology
MH  - Cross-Sectional Studies
MH  - Egypt/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - No-Reflow Phenomenon/diagnosis/epidemiology/*etiology
MH  - Percutaneous Coronary Intervention/*methods
MH  - Retrospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnosis/*physiopathology/surgery
MH  - Time Factors
PMC - PMC7961261
OTO - NOTNLM
OT  - Myocardial infarction
OT  - No-reflow
OT  - Novel predictors
OT  - Outcomes
COIS- Declaration of competing interest There is no conflict of interests.
EDAT- 2021/03/15 06:00
MHDA- 2021/07/28 06:00
PMCR- 2021/01/01
CRDT- 2021/03/14 20:20
PHST- 2020/09/08 00:00 [received]
PHST- 2020/10/27 00:00 [revised]
PHST- 2020/12/17 00:00 [accepted]
PHST- 2021/03/14 20:20 [entrez]
PHST- 2021/03/15 06:00 [pubmed]
PHST- 2021/07/28 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - S0019-4832(20)30458-2 [pii]
AID - 10.1016/j.ihj.2020.12.008 [doi]
PST - ppublish
SO  - Indian Heart J. 2021 Jan-Feb;73(1):35-43. doi: 10.1016/j.ihj.2020.12.008. Epub 
      2020 Dec 29.