Pantea-Roșan Larisa Renata, Pantea Vlad Alin, Bungau Simona, Tit Delia Mirela, Behl Tapan, Vesa Cosmin Mihai, Bustea Cristiana, Moleriu Radu Dumitru, Rus Marius, Popescu Mircea Ioachim, Turi Vladiana, Diaconu Camelia Cristina
Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
Clinical County Emergency Hospital of Oradea, 410169 Oradea, Romania.
J Clin Med. 2020 Sep 12;9(9):2956. doi: 10.3390/jcm9092956.
The no-reflow phenomenon following primary percutaneous coronary intervention (PPCI) in acute ST-elevation myocardial infarction (STEMI) patients is a predictor of unfavorable prognosis. Patients with no-reflow have many complications during admission, and it is considered a marker of short-term mortality. The current research emphasizes the circumstances of the incidence and complications of the no-reflow phenomenon in STEMI patients, including in-hospital mortality. In this case-control study, conducted over two and a half years, there were enrolled 656 patients diagnosed with STEMI and reperfused through PPCI. Several patients ( = 96) developed an interventional type of no-reflow phenomenon. One third of the patients with a no-reflow phenomenon suffered complications during admission, and 14 succumbed. Regarding complications, the majority consisted of arrhythmias (21.68%) and cardiogenic shock (16.67%). The anterior localization of STEMI and the left anterior descending artery (LAD) as a culprit lesion were associated with the highest number of complications during hospitalization. At the same time, the time interval >12 h from the onset of the typical symptoms of myocardial infarction (MI) until revascularization, as well as multiple stents implantations during PPCI, correlated with an increased incidence of short-term complications. The no-reflow phenomenon in patients with STEMI was associated with an unfavorable short-term prognosis.
急性ST段抬高型心肌梗死(STEMI)患者在接受直接经皮冠状动脉介入治疗(PPCI)后出现的无复流现象是预后不良的一个预测指标。无复流患者在住院期间会出现许多并发症,它被认为是短期死亡率的一个标志。当前的研究着重于STEMI患者无复流现象的发生率及并发症情况,包括院内死亡率。在这项持续两年半的病例对照研究中,纳入了656例经诊断为STEMI并通过PPCI实现再灌注的患者。有若干患者(n = 96)出现了介入性无复流现象。三分之一的无复流现象患者在住院期间出现并发症,14例死亡。关于并发症,多数为心律失常(21.68%)和心源性休克(16.67%)。STEMI的前壁定位以及作为罪犯病变的左前降支(LAD)与住院期间最高的并发症发生率相关。同时,从心肌梗死(MI)典型症状发作至血运重建的时间间隔>12小时,以及PPCI期间多个支架植入,均与短期并发症发生率增加相关。STEMI患者的无复流现象与不良的短期预后相关。