The impact of lesion complexity on no-reflow phenomenon and predictors of reversibility in patients treated with primary percutaneous intervention

Durmaz E., Karadag B., Ikitimur B., Atici A., Koca D., Mutlu D., ...Daha Fazla

Coronary Artery Disease, cilt.31, sa.8, ss.678-686, 2020 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 31 Sayı: 8
  • Basım Tarihi: 2020
  • Doi Numarası: 10.1097/mca.0000000000000889
  • Dergi Adı: Coronary Artery Disease
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.678-686
  • Anahtar Kelimeler: no-reflow phenomenon, primary percutaneous intervention, ST-elevation myocardial infarction, SYNTAX score, ACUTE MYOCARDIAL-INFARCTION, CORONARY INTERVENTION, PRIMARY ANGIOPLASTY, REPERFUSION, PREDILATION, PATTERNS
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır

Özet

© 2020 Lippincott Williams and Wilkins. All rights reserved.Objectives Complex coronary lesions are more prone to complications; however, the relationship between complex coronary lesions and no-reflow phenomenon in patients undergoing primary percutaneous intervention (pPCI) is still not clarified. Previous studies reported the association of total coronary artery complexity with no-reflow; however, impact of culprit lesion complexity on no-reflow is not known. In this study, we aimed to investigate the impact of culprit lesion complexity on no-reflow phenomenon. Furthermore, we aimed to investigate the factors that are related to reversibility of no-reflow. Methods We prospectively included 424 patients treated with pPCI. Patients' baseline characteristics and clinical variables were recorded. Reversibility of no-reflow was decided according to final angiography or ST resolution during the first hour following pPCI. There were 90 patients with a diagnosis of no-reflow constituted group 1 and patients without no-reflow constituted group 2. Complexity of coronary artery disease was assessed with SYNTAX score and culprit lesion complexity was assessed with both American College of Cardiology/Society of Cardiovascular Angiography and Interventions lesion classification and SYNTAX score. Results Complexity of culprit lesion was significantly higher in group 1 patients (type C lesion 76.6 vs. 27.8%; P < 0.001 and SYNTAX score 8.7 ± 3.0 vs. 6.2 ± 2.6; P < 0.001, respectively, group 1 vs. 2). Multivariate analyses revealed that lesion complexity is independently associated with no-reflow. Among 90 patients of group 1, 43 patients were classified as reversible no-reflow. Logistic regression analysis revealed that only ischaemia duration is independently associated with reversibility of no-reflow. Conclusion Our study demonstrated that culprit lesion complexity is independently associated with no-reflow phenomenon and short ischaemic duration is significantly associated with reversibility of no-reflow.