No-Reflow Phenomenon in Patients with ST-Elevation Acute Myocardial Infarction, Treated with Primary Percutaneous Coronary Intervention: A Study of Predictive Factors

Abstract

A B S T R A C T Article type: Original article Introduction: No-reflow phenomenon in coronary vessels, manifested in some patients with reperfused acute myocardial infarction (MI), is associated with poor clinical and functional outcomes. Therefore, evaluation of predisposing risk factors can be helpful in risk assessment and identification of patients at higher risk. Herein, we aimed to study the predictive factors for the development of no-reflow phenomenon in patients with ST-elevation acute MI (STEMI), following primary percutaneous coronary intervention (PCI). Materials and Methods: Overall, 141 patients with STEMI, treated with primary PCI, were enrolled in a cross sectional study. Angiographic data associated with no-reflow phenomenon including thrombolysis in MI (TIMI) were evaluated. Patients were divided into study and control (TIMI grade 3) groups. Demographic, clinical and laboratory (lab) data including cardiovascular risk factors (e.g., diabetes, hypertension, hyperlipidemia, smoking), door-to-balloon time, serum creatinine and glucose levels, white and red blood cell counts (WBC and RBC counts, respectively), mean platelet volume (MPV), and red cell distribution width (RDW) were evaluated in both groups. Results: The mean age of the patients was 60.3±11.9 years. No-reflow was observed in 35 (24.8%) cases. WBC count, MPV, serum creatinine, BS, and high-density lipoprotein (HDL) levels were significantly correlated with TIMI flow <3. Conclusion: Certain lab indices including MPV, WBC count, creatinine and HDL levels played significant independent roles in the no-reflow phenomenon. Thus, measuring such parameters might be helpful in predicting the risk of this condition in patients; however, further studies are required.