CLINICAL AND PROCEDURAL PREDICTORS OF NO-REFLOW IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION

Abstract

Objective: To evaluate the clinical and procedural predictors of no reflow in patient with acute myocardial infarction after primary percutaneous coronary intervention in tertiary care cardiac centre.

Study Design: Single centre, prospective observational study.

Place and Duration of study: The study was carried out in Armed Forces institute of Cardiology/ National institute of Heart Disease (AFIC/NIHD) over a period of 06 months From Jan 2015 to June 2015.

Patients and Methods: We collected data of 414 patients who underwent Primary PCI for acute myocardial infarction. Acute myocardial infarction registery by R & D Department was used as a data collection tool. According to Thrombolysis in myocardial infarction (TIMI), the patients were divided into a reflow group and a no-reflow group. The clinical data, angiography findings were compared between the two groups.

Results: Sixty seven (16.18%) of the patients developed no flow phenomenon after primary PCI. Analysis showed that age (> 65yrs), time from onset to reperfusion (>6 hrs), systolic blood pressure (SBP) (<100mm of hg) on admission, Killip class III of myocardial infarction, intra-aortic balloon pump (IABP) use during primary PCI, TIMI flow grade before primary PCI (TIMI <1), type of occlusion, thrombus burden on baseline angiography (high), target lesion length (20mm) and reference luminal diameter (2.5mm)

Conclusion: The occurrence of no-re flow after primary PCI for acute myocardial infarction can be predicted by clinical and angiographic features.