Ajay Sharma, Tarun Kumar, Ankit Gupta, Bhagya Narayan Pandit
BACKGROUND The treatment of acute myocardial infarction (AMI) is thought to restore antegrade blood flow in the infarct-related artery with percutaneous coronary interventions (PCI). The present study was undertaken to identify the clinical factors, biochemical markers, angiographic findings and procedural features which predict the coronary slow flow/no reflow phenomenon in patients with AMI after primary PCI. METHODS A total of 150 patients between 18 to 75 years of age with first episode of AMI undergoing primary PCI were enrolled from January 2015 to June 2016. According to thrombolysis in myocardial infarction (TIMI), patients were divided into normal flow group and slow/no reflow group. The result of primary angioplasty was confirmed on the basis of TIMI flow grade, myocardial blush score and TIMI thrombus grade. Chi-square test was used to analyse categorical variables. Student's t-test and analysis of variance were used for continuous variables. Multivariate analysis was performed to identify independent predictors of noreflow phenomenon. RESULTS Out of 150 patients, 30 (20%) patients developed slowly flow/no reflow after primary PCI. Multivariate analysis showed random blood sugar (p value= 0.031), C-reactive protein (p value= 0.020), higher thrombus grade (p value= 0.07) and length of the stents used (p value= 0.017) were the independent predictors of slow flow/no reflow. CONCLUSIONS The occurrence of slow/no reflow after primary PCI for acute myocardial infarction can be predicted by clinical, biochemical, angiographic and procedural features.
