No-reflow phenomenon predictors after primary PCI in STEMI patients.

Aim: Study of no-reflow phenomenon (NRP) in patients (pts) with STEMI and primary percutaneous coronary intervention (PCI) in relation with age, gender, cardiovascular risk factors, prothrombotic comorbidities (PC), STEMI location on ECG, coronary artery implicated in STEMI, characteristics of obstructive lesion. Method: 131 pts with STEMI, TIMI 3 coronary flow after PCI, were assessed 7 days after primary PCI for NRP using transthoracic Doppler echocardiography (TTDE) of coronary flow velocity [31 men (M) <40 years (24%); 7 women (W) <40 years (5%) not included in statistical analysis; 70M >40 years (53%) and 23 W >40 years (18%)]. Statistics in SPSS 20 with comparisons between groups, correlations and logistic regression; p<0.05 statisticaly significant. Results: NRP diagnosed in 36 pts (27%) was significantly more frequent in M <40 years vs M >40 years (p=0,04), W >40 years vs M >40 years (p=0,02) and was correlated with anterior STEMI [p=0,03, p<0,001, p=0,04], LAD occlusion [p=0,03, p<0,001, p=0,009], coronary obstruction by thrombus in M <40 years (p<0,001) and atherosclerotic plaque in M >40 years (p=0,04). NRP was independently associated with PC [p=0,04, p=0,01], hypertension in M <40 years (p=0,009), dyslipidemia in M >40 years (p=0,003), diabetes and smoking in W >40 years [p=0,04, p=0,03]. Conclusions: No-reflow phenomenon, diagnosed using TTDE coronary flow parameters, occurring in 27% STEMI patients after primary PCI, was positively correlated with LAD obstruction, anterior STEMI, occlusion by thrombus in men under 40 years and atherosclerotic plaque in those over 40 years. The intervention of cardiovascular risk factors seems to be modulated by age and gender. [ABSTRACT FROM AUTHOR]