Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention

Objective. Coronary slow/no reflow is not rare after successfully undergoing primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), and shock index (SI) is an important factor for adverse cardiovascular prognosis. In this study, we are to explore whether...

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Main Authors: Qingcheng Wang, Huimin Shen, Huijuan Mao, Fenghua Yu, Haiqing Wang, Jianlei Zheng
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2019/7873468
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author Qingcheng Wang
Huimin Shen
Huijuan Mao
Fenghua Yu
Haiqing Wang
Jianlei Zheng
author_facet Qingcheng Wang
Huimin Shen
Huijuan Mao
Fenghua Yu
Haiqing Wang
Jianlei Zheng
author_sort Qingcheng Wang
collection DOAJ
description Objective. Coronary slow/no reflow is not rare after successfully undergoing primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), and shock index (SI) is an important factor for adverse cardiovascular prognosis. In this study, we are to explore whether SI is associated with coronary slow/no reflow in patients with AMI following primary PCI. Methods. A total of 153 consecutive AMI patients undergoing primary PCI within 24 hours of symptom onset were included in this study. The participants were divided into normal flow group (n=124) and slow/no reflow group (n=29) according to cineangiograms recorded during the period of PCI. Cardiovascular risk factors, hematologic parameters, preoperative management of antithrombotic therapy, and baseline angiography were collected. Results. SI, plasma glucose, white blood cells (WBC) and neutrophil count, neutrophil to lymphocyte ratio (PLR), high sensitivity C-reactive protein (hs-CRP), probrain natriuretic peptide (pro-BNP), and Killip classification on admission and thrombus burden on initial angiography were significantly different between patients with and without slow/no reflow. Multivariate analysis revealed that SI≥0.66, thrombus burden, and plasma glucose on admission were independent predictors for coronary slow/no reflow. Preoperative management of tirofiban therapy improves initial thrombolysis in myocardial infarction (TIMI). However, it has no effect on prognosis of slow/no reflow. Conclusion. Our findings demonstrated that slow/no reflow in patients with AMI following primary PCI was more likely associated with SI≥0.66, thrombus burden, and plasma glucose on admission. SI as a predictor for coronary slow/no reflow should be further confirmed in the following more large-scale and prospective studies. The clinical registration number is ChiCTR1900024447.
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spelling doaj-art-592ff7619b544d56b1e2c91a2dcf33d32025-08-20T02:05:21ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/78734687873468Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary InterventionQingcheng Wang0Huimin Shen1Huijuan Mao2Fenghua Yu3Haiqing Wang4Jianlei Zheng5Department of Cardiology, Hangzhou Yuhang Hospital of Traditional Chinese Medicine, Yuhang 311106, Zhejiang, ChinaDepartment of Cardiology, Hangzhou Yuhang Hospital of Traditional Chinese Medicine, Yuhang 311106, Zhejiang, ChinaDepartment of Cardiology, Hangzhou Yuhang Hospital of Traditional Chinese Medicine, Yuhang 311106, Zhejiang, ChinaDepartment of Cardiology, Hangzhou Yuhang Hospital of Traditional Chinese Medicine, Yuhang 311106, Zhejiang, ChinaDepartment of Cardiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, ChinaDepartment of Cardiology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou 310014, Zhejiang, ChinaObjective. Coronary slow/no reflow is not rare after successfully undergoing primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI), and shock index (SI) is an important factor for adverse cardiovascular prognosis. In this study, we are to explore whether SI is associated with coronary slow/no reflow in patients with AMI following primary PCI. Methods. A total of 153 consecutive AMI patients undergoing primary PCI within 24 hours of symptom onset were included in this study. The participants were divided into normal flow group (n=124) and slow/no reflow group (n=29) according to cineangiograms recorded during the period of PCI. Cardiovascular risk factors, hematologic parameters, preoperative management of antithrombotic therapy, and baseline angiography were collected. Results. SI, plasma glucose, white blood cells (WBC) and neutrophil count, neutrophil to lymphocyte ratio (PLR), high sensitivity C-reactive protein (hs-CRP), probrain natriuretic peptide (pro-BNP), and Killip classification on admission and thrombus burden on initial angiography were significantly different between patients with and without slow/no reflow. Multivariate analysis revealed that SI≥0.66, thrombus burden, and plasma glucose on admission were independent predictors for coronary slow/no reflow. Preoperative management of tirofiban therapy improves initial thrombolysis in myocardial infarction (TIMI). However, it has no effect on prognosis of slow/no reflow. Conclusion. Our findings demonstrated that slow/no reflow in patients with AMI following primary PCI was more likely associated with SI≥0.66, thrombus burden, and plasma glucose on admission. SI as a predictor for coronary slow/no reflow should be further confirmed in the following more large-scale and prospective studies. The clinical registration number is ChiCTR1900024447.http://dx.doi.org/10.1155/2019/7873468
spellingShingle Qingcheng Wang
Huimin Shen
Huijuan Mao
Fenghua Yu
Haiqing Wang
Jianlei Zheng
Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention
Journal of Interventional Cardiology
title Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention
title_full Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention
title_fullStr Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention
title_full_unstemmed Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention
title_short Shock Index on Admission Is Associated with Coronary Slow/No Reflow in Patients with Acute Myocardial Infarction Undergoing Emergent Percutaneous Coronary Intervention
title_sort shock index on admission is associated with coronary slow no reflow in patients with acute myocardial infarction undergoing emergent percutaneous coronary intervention
url http://dx.doi.org/10.1155/2019/7873468
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