Development and validation of no-reflow phenomenon risk score in patients with acute myocardial infarction

Abstract

Objective To establish a bedside available risk scoring system of no-reflow in the acute stage of STEMI. Methods Data from STEMI patients treated with PCI divided into model group and validation group were analyzed. Multivariable binary logistic regression analysis was used to identify independent no-reflow predictors of the model group. Finally, a score according to the odds ratio on logistic regression analysis was designed, and then risk stratification was established, and no-reflow high-risk patients with myocardial infarction were selected. The authenticity and reliability of the logistic regression courses were validated using receiver operator characteristic curve (ROC) and Hosmer-Lemeshow goodness-of-fit. Results Multivariate logistic regression analysis demonstrated that female (OR=0.587, P=0.019), Killip class of myocardial infarction≥2 (OR=3.656, P 5 was arranged into high risk level. The risk score system demonstrated a good risk prediction in the validation group with AUC of 0.891 (95%CI: 0.822-0.959) based on ROC analysis. ROC analysis in the validation group was applied to Killip class, thrombus burden, score and risk stratification in the validation group , and the no-reflow score was more accurate, with a larger area under the curve ( AUC= 0.851, 95%CI: 0.776-0.927). Conclusions Establishment of no-reflow scoring system with STEMI patients undergoing PCI was benefit to select high risk patients with no-reflow. Key words: Acute ST-segment elevation myocardial infarction; No-reflow phenomenon; Percutaneous coronary intervention; Risk factor; Score