TCT-723 Clinical and Angiographic Predictors of No-Reflow Phenomenon in ST Segment Elevation Myocardial Infarction Treated with Successful Primary Percutaneous Intervention

Arcay, Luis; Braghiroli, Joao; Silva-Chuecos, Maria; Blumer, Vanessa; Chait, Robert; Cardenas, Gustavo A.

doi:10.1016/j.jacc.2017.09.960

Cited by 1 publication

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“…Also another study was done on 212 patients diagnosed with STEMI who underwent primary PCI in 2012-2013 at JFK medical Center. The glucose on admission were significantly higher in the no-reflow group (19) .…”

Section: Discussionmentioning

confidence: 82%

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Clinical and Laboratory Predictors of No-reflow during Primary Percutaneous Coronary Intervention

Mansour

El-Abd

Ghazy

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: The phenomenon of no-reflow is defined as the occurrence of areas with very low tissue flow after the target vessel has reopened. Current knowledge suggests that the no-reflow phenomenon is caused by the damage to microvascular integrity established both during ischemia and during reperfusion. D-dimer is the end product of fibrin degradation by plasmin, as plasma concentrations increase in people with persistent or recent thrombosis. Its levels reflect the rate of fibrin turnover and give an indirect estimate of the size of the coagulant mass available for fibrinolysis and the severity of the hypercoagulable condition. Objective: To investigate the Clinical and laboratory predictors of no-reflow on admission after primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) patients. Patients and methods: A prospective single group observational study. A total of 100 patients presented with STEMI and eligible for primary PCI to the cardiology department in Ain Shams University hospital. Results: Coronary angiography showed that (74%) had normal flow while (26%) showed no re-flow. Renal impairment, DM and delayed reperfusion (> 4 hr) were significantly associated with no reflow(P-values = 0.018,0.023,0.005) respectively. ROC curve showed that the best cut off point for D-dimer to predict cases with no reflow was found ≥ 560 with sensitivity of 96.15%, specificity of 79.73% and area under curve (AUC) of 86.5% where as the best cut off point for CRP was > 41 with sensitivity of 76.92%, specificity of 64.86% and area under curve (AUC) of 69.8. Conclusion: Assessment of D-dimer and CRP levels on admission in STEMI patients might independently predicts no-reflow after primary PCI.

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Section: Discussionmentioning

confidence: 82%

“…There was an agreement with the previous literature, in which D-dimer levels were higher in the patients with electrocardiographic no-reflow (P < 0.001). The univariate analysis declared that plasma D-dimer level was significantly predictive of both angiographic (P < 0.001) and electrocardiographic no-reflow phenomenon (P < 0.001) (19) .…”

Section: Discussionmentioning

confidence: 98%