Analysis of risk factors for non-reflow phenomenon during primary percutaneous coronary intervention in patients with first acute ST-segment-elevation myocardial infarction
10.3760/cma.j.issn.1008?6315.2018.02.001
- VernacularTitle:首次急性ST段抬高型心肌梗死患者行直接经皮冠状动脉介入术发生无复流的危险因素分析
- Author:
Yong LI
1
;
Shuzheng LYU
Author Information
1. 首都医科大学附属北京安贞医院急诊危重症中心
- Keywords:
Coronary disease;
Myocardial infarction;
Non reflow;
Bradycardia;
Primary percutaneous coronary intervention
- From:Clinical Medicine of China
2018;34(2):105-109
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of non?reflow phenomenon during primary percutaneous coronary intervention ( PPCI ) in patients with first acute ST?segment?elevation myocardial infarction ( STEMI ) . Methods Four hundred and forty?eight first acute STEMI patients who had PPCI from January 2007 to October 2010 in Beijing Anzhen Hospital were enrolled in this study. All patients were divided into two groups according to thrombolysis in myocardial infarction( TIMI) coronary flow grade during PPCI:non?reflow group(44 cases,TIMI 0?2 grade) and control group(404 cases,TIMI 3 grade). The basic clinical data, radiographic findings and operative data of the two groups were compared. The risk factors of non?reflow during PPCI operation in the first acute STEMI patients were analyzed. Results Non?reflow phenomenon occurred in 44 cases in the non?reflow group and 404 cases in the control group,the incident rate was 9. 82％(44/448) . Logistic regression analysis showed that the differences between the two groups in the completely block of culprit vessel,intraoperative bradycardia( preoperative heart rate ≥60 times / min,persistent or transient intraoperative heart rate < 60 times / min) ,age,percentage of neutrophils and other parameters were statistically significant ( P<0. 05) . Multivariate Logistic regression analysis showed that intraoperative bradycardia ( OR=3. 106,95％ CI:1. 584～6. 090) and age ( OR=1. 040,95％ CI: 1. 010～1. 070) could be used as independent risk factors for predicting non?reflow in PPCI. Conclusion Age of the patient and the occurrence of bradycardia may be independent risk factors for predicting the non reflow of PPCI in the first acute STEMI patients.
