Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction

Abstract Background Emergency percutaneous coronary intervention (PCI) is a common treatment for ST-elevated myocardial infarction (STEMI) patients. However, the coronary slow flow/no reflow phenomenon (CSF/NRP) can occur as a complication during or after the procedure. Identifying predictors of CSF...

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Main Authors: Fatemeh Bamarinejad, Mohammad Kermani-alghoraishi, Azam Soleimani, Hamidreza Roohafza, Safoura Yazdekhasti, Maedeh Azarm, Atefeh Bamarinejad, Masoumeh Sadeghi
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Language:English
Published: SpringerOpen 2024-11-01
Series:The Egyptian Heart Journal
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Online Access:https://doi.org/10.1186/s43044-024-00577-0
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author Fatemeh Bamarinejad
Mohammad Kermani-alghoraishi
Azam Soleimani
Hamidreza Roohafza
Safoura Yazdekhasti
Maedeh Azarm
Atefeh Bamarinejad
Masoumeh Sadeghi
author_facet Fatemeh Bamarinejad
Mohammad Kermani-alghoraishi
Azam Soleimani
Hamidreza Roohafza
Safoura Yazdekhasti
Maedeh Azarm
Atefeh Bamarinejad
Masoumeh Sadeghi
author_sort Fatemeh Bamarinejad
collection DOAJ
description Abstract Background Emergency percutaneous coronary intervention (PCI) is a common treatment for ST-elevated myocardial infarction (STEMI) patients. However, the coronary slow flow/no reflow phenomenon (CSF/NRP) can occur as a complication during or after the procedure. Identifying predictors of CSF/NRP after emergency PCI in STEMI patients can help clinicians anticipate and prevent this complication. In this study, we aimed to investigate clinical, laboratory, and procedural factors that may contribute to the development of CSF/NRP in STEMI patients undergoing PCI. Results A total of 460 patients were included in this study, with a mean (± SD) age of 60 ± 12.5 years. The incidence of CSF/NRP was 30.2% (n = 139) among the study population. The univariate analysis showed that older age, lower left ventricular ejection fraction (LVEF), initial thrombolysis in myocardial infarction (TIMI)flow grade 0–2, increased creatinine level, lower estimated glomerular filtration rate (eGFR), diffuse target lesion length, and longer length of stent were significantly associated with the occurrence of CSF/NRP (p < 0.05). However, in the multivariate logistic regression model, only eGFR (OR = 0.98, 95% CI: 0.96–0.99, p = 0.005), diffuse target lesion length (OR = 2.15, 95% CI: 1.20–3.83, p = 0.009) and LVEF (OR = 0.96, 95% CI: 0.94–0.98, p = 0.004) remained significant predictors of CSF/NRP. Conclusions The present study demonstrated that diffuse lesion length, lower LVEF, and lower eGFR can be considered as independent predictors of CSF/NRP in STEMI patients.
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spelling doaj-art-3c19aeb9c265436d8711c5b73c5d44b22025-08-20T02:13:26ZengSpringerOpenThe Egyptian Heart Journal2090-911X2024-11-017611910.1186/s43044-024-00577-0Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarctionFatemeh Bamarinejad0Mohammad Kermani-alghoraishi1Azam Soleimani2Hamidreza Roohafza3Safoura Yazdekhasti4Maedeh Azarm5Atefeh Bamarinejad6Masoumeh Sadeghi7Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesInterventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesDepartment of Cardiology, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical SciencesIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesCardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical SciencesAbstract Background Emergency percutaneous coronary intervention (PCI) is a common treatment for ST-elevated myocardial infarction (STEMI) patients. However, the coronary slow flow/no reflow phenomenon (CSF/NRP) can occur as a complication during or after the procedure. Identifying predictors of CSF/NRP after emergency PCI in STEMI patients can help clinicians anticipate and prevent this complication. In this study, we aimed to investigate clinical, laboratory, and procedural factors that may contribute to the development of CSF/NRP in STEMI patients undergoing PCI. Results A total of 460 patients were included in this study, with a mean (± SD) age of 60 ± 12.5 years. The incidence of CSF/NRP was 30.2% (n = 139) among the study population. The univariate analysis showed that older age, lower left ventricular ejection fraction (LVEF), initial thrombolysis in myocardial infarction (TIMI)flow grade 0–2, increased creatinine level, lower estimated glomerular filtration rate (eGFR), diffuse target lesion length, and longer length of stent were significantly associated with the occurrence of CSF/NRP (p < 0.05). However, in the multivariate logistic regression model, only eGFR (OR = 0.98, 95% CI: 0.96–0.99, p = 0.005), diffuse target lesion length (OR = 2.15, 95% CI: 1.20–3.83, p = 0.009) and LVEF (OR = 0.96, 95% CI: 0.94–0.98, p = 0.004) remained significant predictors of CSF/NRP. Conclusions The present study demonstrated that diffuse lesion length, lower LVEF, and lower eGFR can be considered as independent predictors of CSF/NRP in STEMI patients.https://doi.org/10.1186/s43044-024-00577-0ST-elevated myocardial infarctionPercutaneous coronary interventionCoronary slow flow phenomenonNo reflowPredictor
spellingShingle Fatemeh Bamarinejad
Mohammad Kermani-alghoraishi
Azam Soleimani
Hamidreza Roohafza
Safoura Yazdekhasti
Maedeh Azarm
Atefeh Bamarinejad
Masoumeh Sadeghi
Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction
The Egyptian Heart Journal
ST-elevated myocardial infarction
Percutaneous coronary intervention
Coronary slow flow phenomenon
No reflow
Predictor
title Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction
title_full Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction
title_fullStr Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction
title_full_unstemmed Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction
title_short Clinical, laboratory, and procedural predictors of slow flow/no reflow phenomenon after emergency percutaneous coronary interventions in ST-elevated myocardial infarction
title_sort clinical laboratory and procedural predictors of slow flow no reflow phenomenon after emergency percutaneous coronary interventions in st elevated myocardial infarction
topic ST-elevated myocardial infarction
Percutaneous coronary intervention
Coronary slow flow phenomenon
No reflow
Predictor
url https://doi.org/10.1186/s43044-024-00577-0
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