title: A no-reflow prediction model in patients with ST-elevation acute myocardial infarction and primary drug-eluting stenting.
abstract: OBJECTIVE
  This study was undertaken to assess independent no-reflow predictors in patients with ST-elevation acute myocardial infarction (STEMI) and primary drug-eluting stenting in the current interventional strategies.
  
  
  METHODS
  One thousand four hundred and thirteen patients with STEMI were successfully treated with primary drug-eluting stenting within 12 h after AMI. All clinical, angiographic and procedural data were collected. Univariate and multivariate logistic regression was used to identify independent no-reflow predictors.
  
  
  RESULTS
  The no-reflow was found in 297 (21%) of 1413 patients. Univariate and multivariate logistic regression identified that age (>65 years, OR 1.47, 95% CI 1.46-1.49; p = 0.007), long time-to-reperfusion (>6 h, OR 1.27, 95% CI 1.16-1.40; p = 0.001), admission plasma glucose (>13.0 mmol/L, OR 1.27, 95% CI 1.16-1.40; p = 0.027), collateral circulation (0-1, OR 1.69, 95% CI 1.25-2.29; p = 0.001), pre-PCI thrombus score (≥4, OR 1.36, 95% CI 1.16-1.79; p = 0.011), and IABP use before PCI (OR 2.89, 95% CI 1.65-5.05; p < 0.0001) were independent no-reflow predictors. The no-reflow rate significantly increased as the number of independent predictors increased (0%, 6%, 15%, 25%, 40%, 50% and 100% in patients with 0, 1, 2, 3, 4, 5, and 6 independent predictors, respectively; p < 0.0001).
  
  
  CONCLUSIONS
  The prediction model consisted of six no-reflow predictors in patients with STEMI and primary drug-eluting stenting and should be confirmed in large-scale prospective studies.
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, Beijing, China. wch1201@126.com
authors.forename: Chang-Hua
authors.initials: CH
authors.lastname: Wang
authors.forename: Yun-Dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Xin-Chun
authors.initials: XC
authors.lastname: Yang
authors.forename: Le-Feng
authors.initials: LF
authors.lastname: Wang
authors.forename: Hong-Shi
authors.initials: HS
authors.lastname: Wang
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Sun
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Liu
mesh_terms: D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001786:Blood Glucose / Q000032:analysis; D003097:Collateral Circulation; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy*; D015425:Myocardial Reperfusion; D054318:No-Reflow Phenomenon / Q000097:blood; D011300:Preoperative Care; D011446:Prospective Studies; D012044:Regression Analysis; D013927:Thrombosis / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose