The relationship between serum rheumatoid factor level and no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Abstract

This study aimed to evaluate the relationship between serum rheumatoid factor (RF) levels and no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). This single-center, cross-sectional study included a total of 318 consecutive patients who were diagnosed with STEMI and underwent primary PCI within 12hours of the onset of symptoms. Baseline serum RF levels of all patients were measured. The diagnosis of no-reflow phenomenon was defined as a flow of TIMI II or less without the presence of dissection, mechanical obstruction, significant residual stenosis, or other plausible causes. The patients were divided into reflow group (n=283) and no-reflow group (n=46) regarding the angiographic features of thrombolysis in myocardial infarction (TIMI) flow of the infarct-related artery. No-reflow phenomenon was observed in 13.8% of the patients. Median RF level was significantly higher in no-reflow group than in reflow group (18.5 (7.0-27.6) vs 8.0 (4.6-50.8), P<.001). Forward conditional logistic regression analysis demonstrated that body mass index (OR=0.845, 95% CI: 0.765 to 0.933, P=.001), diabetes mellitus (OR=5.257, 95% CI: 1.124 to 24.587, P=.035), baseline RF level (OR=1.198, 95% CI: 1.108 to 1.295, P<.001), and SYNTAX score I (OR=1.065, 95% CI: 1.025 to 1.107, P=.001) were the independent predictors of no-reflow phenomenon. Baseline serum RF concentrations are independently associated with the no-reflow phenomenon in patients undergoing primary PCI for acute STEMI.