Amirpour Afshin, Behjati Mohammad Amin, Zavar Reihaneh, Shirvani Ehsan, Zarepour Ehsan, Hassannejad Razieh, Sadeghi Masoumeh, Janghorbanian Poodeh Raheleh, Safaei Ali, Sanaei Shahin, Parvar Nazanin Mahin
Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
ARYA Atheroscler. 2024 Mar-Apr;20(2):31-40. doi: 10.48305/arya.2024.42104.2921.
Percutaneous coronary intervention (PCI) is the gold standard approach to ST-Segment Elevation Myocardial Infarction (STEMI). Fibrinolysis followed by PCI has been recommended. The current study aims to investigate the no-reflow phenomenon incidence in patients undergoing post-thrombolytic therapy PCI.
This cross-sectional study was conducted on 250 patients with STEMI who primarily received fibrinolytic therapy followed by early (3-24 hours) (n=231) or delayed (> 24 hours) (n=19) PCI. They were also subcategorized into four intervals: <6 hours (n=98), 6-12 hours (n=93), 12-24 hours (n=38), and ≥24 hours (n=21). The demographic and medical data of the patients were retrieved. The Thrombolysis in Myocardial Infarction score (TIMI) was assessed at baseline and at the end of PCI. A TIMI score other than 3 was defined as no-reflow.
The incidence of the no-reflow phenomenon was not associated with any of the underlying demographic and medical characteristics of the patients (P-value>0.05). Despite the significantly higher rate of improvement in TIMI grading among those undergoing early PCI (P-value=0.04), as well as within less than 6 hours after thrombolytic therapy (P-value=0.031), the rate of the no-reflow phenomenon did not differ between the groups, neither by sorting them as early versus delayed (P-value=0.518) nor by categorizing them into four intervals (P-value=0.367).
Based on the findings of the current study, early PCI after fibrinolysis led to significantly improved TIMI flow. However, the incidence of no-reflow did not differ between the groups with early versus delayed post-fibrinolysis PCI.
经皮冠状动脉介入治疗（PCI）是ST段抬高型心肌梗死（STEMI）的金标准治疗方法。推荐先进行溶栓治疗，随后进行PCI。本研究旨在调查溶栓后接受PCI治疗患者的无复流现象发生率。
本横断面研究对250例STEMI患者进行，这些患者主要接受溶栓治疗，随后进行早期（3 - 24小时）（n = 231）或延迟（> 24小时）（n = 19）PCI。他们还被分为四个时间段：<6小时（n = 98）、6 - 12小时（n = 93）、12 - 24小时（n = 38）和≥24小时（n = 21）。收集患者的人口统计学和医学数据。在基线和PCI结束时评估心肌梗死溶栓评分（TIMI）。TIMI评分非3被定义为无复流。
无复流现象的发生率与患者的任何潜在人口统计学和医学特征均无关联（P值>0.05）。尽管早期PCI患者（P值 = 0.04）以及溶栓治疗后不到6小时内患者（P值 = 0.031）的TIMI分级改善率显著更高，但无复流现象的发生率在两组之间并无差异，无论是按早期与延迟分类（P值 = 0.518）还是按四个时间段分类（P值 = 0.367）。
基于本研究结果，溶栓后早期PCI可显著改善TIMI血流。然而，溶栓后早期与延迟PCI组之间的无复流发生率并无差异。
