Volume 3, Issue 2, June 2019, Page: 22-26
Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention
Khaled Mohamed Said Othman, Cardiology Department, Ain Shams University, Cairo, Egypt
Hesham Samir Abdelaziz AbdelKawy Aggour, Cardiology Department, Ain Shams University, Cairo, Egypt
Samir Saleh Wafa, Cardiology Department, Ain Shams University, Cairo, Egypt
Mohamed El Sayed Zahran, Cardiology Department, Ain Shams University, Cairo, Egypt
Received: Mar. 30, 2019;       Accepted: May 7, 2019;       Published: Jun. 11, 2019
DOI: 10.11648/j.ccr.20190302.11      View  525      Downloads  65
Background Primary Percutaneous coronary intervention (PPCI) is an established mainstay in treatment of patients presenting with acute ST elevation myocardial infarction (STEMI). However, successful revascularization of the culprit coronary vessel does not always mean ideal myocardial reperfusion in a portion of patients, mainly because of the no-reflow phenomenon. Myocardial no-reflow is associated with worse contractile dysfunction and higher incidence of complications and is an independent predictor of death and myocardial infarction after PPCI. Objective: To study the relationship between admissions CRP, Albumin, CRP/Albumin ratio, Monocyte, HDL, and Monocyte/HDL ratio, in patients presenting with acute STEMI and angiographic no-reflow after PPCI. Material and Methods: From October 2018 to February 2019, of the 1500 patients who presented with STEMI for PPCI to any of the Ain Shams University Hospitals’ cath labs, we enrolled 150 consecutive patients who had post revascularization angiographic no-reflow. They were allocated to group A. we allocated 150 age, gender, and baseline characteristics matched STEMI patients who had TIMI III flow post revascularization to group B. this was set as the control group. Results: The study population was divided into 2 groups: no-reflow “A” (n = 150) and reflow “B” (n = 150) groups. CRP and Monocytes were significantly higher in the no-reflow group; Albumin and HDL were significantly lower in the no-reflow group. The novel indices, CRP/Albumin ratio (CAR) and Monocytes/HDL ratio (MHR) were both significantly higher in the no-reflow group (p value = 0.000) for both. The tow indices were found to be independent predictors of no-reflow development. Conclusion: Our results suggested that CAR and MHR on admission before PPCI though cheap, and easily measurable laboratory tools, have a significant predictive value with an odds ratio of 0.182 with a p value = 0.000 and 0.321 with a p value = 0.002 respectively. They could help to risk stratify STEMI patients who might suffer from no-reflow phenomenon after PPCI.
No-reflow, CRP/Albumin Ratio, Monocytes/HDL Ratio
To cite this article
Khaled Mohamed Said Othman, Hesham Samir Abdelaziz AbdelKawy Aggour, Samir Saleh Wafa, Mohamed El Sayed Zahran, Predictors of No-reflow Phenomenon in ST-elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention, Cardiology and Cardiovascular Research. Vol. 3, No. 2, 2019, pp. 22-26. doi: 10.11648/j.ccr.20190302.11
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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