Prognostic assesment of no-reflow after primary percutaneous coronary intervention in elderly patients with ST-elevation acute myocardial infarction
10.3760/cma.j.issn.0254-9026.2011.09.001
- VernacularTitle:老年ST段抬高型急性心肌梗死患者急诊冠状动脉介入术后无复流的预测因素
- Author:
Changhua WANG
;
Yundai CHEN
;
Xinchun YANG
;
Lefeng WANG
;
Hongshi WANG
;
Zhijun SUN
;
Hongbin LIU
;
Lian CHEN
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Angioplasty,transluminal,percutaneous coronary;
No-reflow phenomenon
- From:
Chinese Journal of Geriatrics
2011;30(9):705-709
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify independent predictors of no-reflow after primary percutaneous coronary intervention (PPCI)in aged patients with ST-elevation acute myocardial infarction (STEMI), and thus construct a no-reflow predicting model.MethodsTotal of 668 aged patients with STEMI and successfully treated with PPCI were divided into the no-reflow group and the normal flow group. All clinical, angiographic and procedural data were collected. Multiple logistic regression analysis was used to identify independent no-reflow predictors.ResultsThe no-reflow was found in 181 of 668 (27.1％) patients.Multiple stepwise logistic regression analysis identified that admission systolic blood pressure (SBP)＜100 mm Hg, collateral circulation 0-1 grade, pre-PCI thrombus score ≥ 4, and intra-aortic balloon pump (IABP) use before PCI were independent noreflow predictors.The no-reflow incidence significantly enhanced as the numbers of independent predictors increased [10.0％ (2/20), 13.7％ (32/233), 30.8％ (85/276), 38.1％ (37/97), and 59.5％ (25/42) in patients with 0, 1, 2, 3, and 4 independent predictors, respectively,x2 =25.796,P＜0.01) ]. ConclusionsThe no-reflow predictors are admission SBP ＜ 100 mm Hg, collateral circulation 0-1grade, pre-PCI thrombus score≥4, and IABP use before PCI in patients with STEMI and treated with PPCI. The prediction model may provide basis for therapeutic decision.
