Clinical and procedural predictors and short-term survival of the patients with no reflow phenomenon after primary percutaneous coronary intervention

Ashraf, Tariq; Khan, M. Gabriel; Afaque, Syed Muhammad; Fatima, Kanwal; Kumar, Mukesh; Saghir, Tahir; Rasool, Syed Ishtiaq; Rizvi, Syed Nadeem Hassan; Sial, Jawaid Akbar; Nadeem, Asif; Khan, Abid Amin; Karim, Musa

doi:10.1016/j.ijcard.2019.07.067

Cited by 37 publications

(37 citation statements)

References 18 publications

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“…The pathophysiology of the no-reflow phenomenon is complex, and a series of consistent data has [ 27 , 28 ] clearly shown that the no-reflow phenomenon has a strong negative effect on the outcome. In a population-based global registry, the NCDR study reported [ 29 ] that the no-reflow phenomenon is associated with an increased risk of adverse postprocedure hospital course including higher in-hospitality mortality (6.8% vs. 2.9%; p = 0.01), cerebrovascular accident (1.5% vs. 0%; p < 0.001), postprocedure bleeding (2.3% vs. 0.5%; p = 0.009), and cardiogenic shock (3.8% vs. 1.2%; p = 0.011). The no-reflow phenomenon is a process in which prolonged ischemia caused changes in endothelial cells, and optimal treatment of hyperglycemia is a significant target in preventing [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Variation of Troponin and Prognosis of Acute Myocardial Infarction before and after Primary Percutaneous Coronary Intervention

Zhao

Wang

Liu

et al. 2020

Journal of Interventional Cardiology

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Background. Circulating levels of cardiac troponin I (cTnI) after ST-segment elevation myocardial infarction (STEMI) were considered as prognostic factors for predicting the incidence of major adverse cardiovascular events (MACE). △cTnI is the difference between peak cTnI after primary percutaneous coronary intervention (PPCI) and cTnI on initial admission. Purpose. This study aimed to assess the relationship between △cTnI, the ratio of △cTnI to cTnI on initial admission, and the incidence of MACE during the follow-up period. Methods. A total of 2596 patients with cTnI measured upon admission and one-time measurement of cTnI during hospitalization were enrolled. Results. In the adjusted models of the survival receiver operating characteristic (ROC) curve, △cTnI and the ratio of △cTnI to cTnI on initial admission have stronger discrimination power of MACE (area under curve (AUC) 0.730 and 0.717) compared with peak cTnI after PPCI and cTnI at admission (AUC 0.590, 0.546). Multivariate Cox regression analysis identified △cTnI (hazard ratio (HR) 1.018, 95% confidence interval (CI) 1.001 to 1.035) as a relevant factor for MACE during follow-up. △cTnI was divided into quartiles, and maximum △ cTnI between 4.845 and 19.073 ng/ml comprised more patients with anterior wall myocardial infarction (p < 0.001), higher GRACE score (p = 0.038), CK-MB (p = 0.023), and Myoglobin (p < 0.001). On the K–M survival curves, the incidence of MACE, mortality, and angina pectoris were significantly higher in the group with maximum △cTnI (p = 0.035, 0.049, 0.026). Conclusion. The △cTnI level and the ratio of △cTnI have stronger discrimination power of predicting the incidence of MACE. The group with maximum △cTnI has higher incidence of MACE, mortality, and angina pectoris during the follow-up period.

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Section: Discussionmentioning

confidence: 99%

Association between Variation of Troponin and Prognosis of Acute Myocardial Infarction before and after Primary Percutaneous Coronary Intervention

Zhao

Wang

Liu

et al. 2020

Journal of Interventional Cardiology

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“…Del Turco and Colleagues [9] demonstrated that elderly patients (>65 years) suffer from higher rates of no-reflow, attributable to a more pronounced pro-inflammatory state, defined by presence of higher mean values of fibrinogen, brain natriuretic peptide, leukocytes, neutrophil-to-lymphocyte ratio and C reactive protein-albumin ratio. Moreover, in a large cohort of patients undergoing pPCI, Ashraf et al [10], found that age, diabetes, prior history of coronary artery bypass grafting, higher thrombus burden and longer lesion length were independent predictors of no-reflow. Corroborating the idea that more pronounced the patient-related thrombotic diathesis, higher the risk of suboptimal reperfusion, Kaya et al [11] showed that the presence of atrial fibrillation is associated with 2-fold increase of risk to develop no-reflow in STEMI patients.…”

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confidence: 99%

No-reflow phenomenon in acute myocardial infarction: Relieve pressure from the procedure and focus attention to the patient

Buono

Gori²

2019

IJC Heart & Vasculature

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“…The rate of adverse events in this cohort was relatively much higher than the outcomes of primary PCI that were previously reported in large registry-based studies from our population. The reported in-hospital rate of mortality and heart failure ranged from 2.2% to 3.04% and 0.7% to 0.9%, respectively, with cardiogenic shock up to 1.3% [ 16 - 18 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Primary Percutaneous Coronary Intervention in Patients With a Thrombolysis in Myocardial Infarction Score of Five or Higher

Talreja¹,

Sheikh²,

Rahman³

et al. 2020

Cureus

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Background Primary percutaneous coronary intervention (PCI) is a treatment of choice for patients with STsegment elevation myocardial infarction (STEMI). Of the various risk stratification scores that have been introduced, the thrombolysis in myocardial infarction (TIMI) score is among the most used modalities. Patients with a TIMI score of five or higher are classified as high-risk patients with higher rates of adverse events. Therefore, this study aimed to determine the rate of adverse events after primary PCI in patients presenting with STEMI and a TIMI score of five or higher. Methodology This descriptive study was conducted at the cardiology department of the Liaquat National Hospital, Karachi, from February 2018 to August 2018. The patients included in this study consisted of a total of 150 men and women who presented to the ED with concerns of chest pain and were diagnosed with STEMI and had a TIMI score of five or higher. Consultant cardiologists performed primary PCI procedures, and any post-procedure adverse events were recorded during the patients' hospital stays (up to one week), including mortality, heart failure, cardiogenic shock, and ventricular arrhythmias. Results The study population was 83.3% male and 16.7% female patients, and the mean age was 54.0 ± 9.4 years. The mean BMI was 27.34 ± 2.76 kg/m 2. The mean TIMI score was 9.19 ± 2.71, with a TIMI score higher than eight for 52.7% of patients. Death was observed in 18.7% of cases, heart failure in 21.3% of cases, cardiogenic shock in 13.3% of cases, and ventricular arrhythmia in 22.0% of cases. Conclusion A TIMI risk score of five or higher can identify patients at high risk not only for mortality, but also for heart failure, cardiogenic shock, and ventricular arrhythmias.

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Clinical and procedural predictors and short-term survival of the patients with no reflow phenomenon after primary percutaneous coronary intervention

Cited by 37 publications

References 18 publications

Association between Variation of Troponin and Prognosis of Acute Myocardial Infarction before and after Primary Percutaneous Coronary Intervention

Association between Variation of Troponin and Prognosis of Acute Myocardial Infarction before and after Primary Percutaneous Coronary Intervention

No-reflow phenomenon in acute myocardial infarction: Relieve pressure from the procedure and focus attention to the patient

Outcomes of Primary Percutaneous Coronary Intervention in Patients With a Thrombolysis in Myocardial Infarction Score of Five or Higher

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