Huyut Mustafa Ahmet, Yamac Aylin Hatice
Yeni Yuzyil University - Cardiology, Istanbul - Turquia.
Bezmialem Vakif University - Cardiology, Istanbul - Turquia.
Arq Bras Cardiol. 2021 Feb;116(2):238-247. doi: 10.36660/abc.20190656.
Coronary no-reflow phenomenon (CNP) is associated with an increased risk of major cardiovascular adverse events (MACE).
This study aimed to evaluate the relationship between serum Kidney Injury Molecule-1 (KIM-1) levels and CNP in patients with acute ST-segment elevation myocardial infarction (STEMI).
This study included a total of 160 patients (113 males and 47 females; mean age: 61.65±12.14 years) who were diagnosed with STEMI. The patients were divided into two groups, the reflow group (RG) (n=140) and the no-reflow group (NRG) (n=20). Patients were followed during one year. A p-value of <0.05 was considered significant.
CNP was observed in 12.50% of the patients. Serum KIM-1 was significantly higher in the NRG than in the RG (20.26±7,32 vs. 13.45±6.40, p<0.001). Body mass index (BMI) was significantly higher in the NRG than in the RG (29.41 (28.48-31.23) vs. 27.56 (25.44-31.03), p=0.047). Heart rate (HR) was significantly lower in the NRG than in the RG (61.6±8.04 vs. 80.37±14.61, p<0.001). The European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) was significantly higher in the NRG than in the RG (3.06±2.22 vs. 2.36±2.85, p=0.016). The incidence of stroke was significantly higher in the NRG than in the RG (15% vs. 2.90%, p=0.013). The baseline KIM-1 level (OR=1.19, 95% CI:1.07 to 1.34, p=0.002) and HR (OR=0.784, 95% CI:0.69 to 0.88, p<0.001) were the independent predictors of CNP.
In conclusion, baseline serum KIM-1 concentrations and lower HR are independently associated with CNP in STEMI patients and the incidence of stroke was significantly higher in the NRG in the one-year follow-up. (Arq Bras Cardiol. 2021; 116(2):238-247).
冠状动脉无复流现象（CNP）与主要心血管不良事件（MACE）风险增加相关。
本研究旨在评估急性ST段抬高型心肌梗死（STEMI）患者血清肾损伤分子-1（KIM-1）水平与CNP之间的关系。
本研究共纳入160例诊断为STEMI的患者（男性113例，女性47例；平均年龄：61.65±12.14岁）。患者分为两组，复流组（RG）（n = 140）和无复流组（NRG）（n = 20）。对患者进行为期一年的随访。p值<0.05被认为具有统计学意义。
12.50%的患者出现CNP。NRG组血清KIM-1水平显著高于RG组（20.26±7.32 vs. 13.45±6.40，p<0.001）。NRG组的体重指数（BMI）显著高于RG组（29.41（28.48 - 31.23）vs. 27.56（25.44 - 31.03），p = 0.047）。NRG组的心率（HR）显著低于RG组（61.6±8.04 vs. 80.37±14.61，p<0.001）。欧洲心脏手术风险评估系统II（EuroSCORE II）在NRG组显著高于RG组（3.06±2.22 vs. 2.36±2.85，p = 0.016）。NRG组中风发生率显著高于RG组（15% vs. 2.90%，p = 0.013）。基线KIM-1水平（OR = 1.19，95%CI：1.07至1.34，p = 0.002）和HR（OR = 0.784，95%CI：0.69至0.88，p<0.001）是CNP的独立预测因素。
总之，基线血清KIM-1浓度和较低的HR与STEMI患者的CNP独立相关，且在一年随访中NRG组中风发生率显著更高。（《巴西心脏病学杂志》。2021；116(2)：238 - 247）
