[Predictors of the no-reflow phenomenon after primary percutaneous coronary intervention for acute myocardial infarction].

OBJECTIVE

To identify the risk factors for no-reflow (NR) phenomenon after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction.

METHODS

A total of 843 patients with AMI underwent primary PCI within 12 h following onset of the ischemic symptoms. According to TIMI flow grade and myocardial blush grade, the patients were divided into reflow group and NR group after primary PCI, and the clinical data, angiography findings and surgical data were compared to analyze the factors contributing to NR.

RESULTS

NR occurred in 15.9% of the AMI patients after primary PCI. Univariate analysis showed that previous myocardial infarction, Killip classes of MI, time to reperfusion, IABP use before PCI, TIMI flow grade before primary PCI, long target lesion, pre-PCI thrombus score and method of reperfusion were correlated to NR (P<0.05 ). Multiple logistic analysis identified the time to reperfusion (OR=1.60; 95% CI: 1.02-2.73), TIMI flow grade before primary PCI (OR=1.1; 95% CI: 1.04-1.16), long target lesion (OR=1.40; 95% CI: 1.19-1.69), and pre-PCI thrombus score (OR=2.02; 95% CI: 1.47-2.76) as the independent predictors of NR after primary PCI.

CONCLUSION

The time to reperfusion, TIMI flow grade before primary PCI, long target lesion, and pre-PCI thrombus score are independent predictors of NR after primary PCI for AMI.