title: Independent no-reflow predictors in female patients with ST-elevation acute myocardial infarction treated with primary percutaneous coronary intervention.
abstract: Independent no-reflow predictors should be evaluated in female patients with ST-segment elevation acute myocardial infarction (STEMI) and successfully treated with primary percutaneous coronary intervention (PPCI) in the current interventional equipment and techniques, thus to be constructed a no-reflow predicting model. In this study, 320 female patients with STEMI were successfully treated with PPCI within 12 h after the onset of AMI from 2007 to 2010. All clinical, angiographic, and procedural data were collected. Multiple logistic regression analysis was used to identify independent no-reflow predictors. The no-reflow was found in 81 (25.3%) of 320 female patients. Univariate and multivariate stepwise logistic regression analysis identified that low SBP on admission <100 mmHg (OR 1.991, 95% CI 1.018-3.896; p = 0.004), target lesion length >20 mm (OR 1.948, 95% CI 1.908-1.990; p = 0.016), collateral circulation 0-1 (OR 1.952, 95% CI 1.914-1.992; p = 0.019), pre-PCI thrombus score ≥ 4 (OR 4.184, 95% CI 1.482-11.813; p = 0.007), and IABP use before PCI (OR 1.949, 95% CI 1.168-3.253; p = 0.011) were independent no-reflow predictors. The no-reflow incidence significantly increased as the numbers of independent predictors increased [0% (0/2), 10.8% (9/84), 14.5% (17/117), 37.7% (29/77), 56.7% (17/30), and 81.8% (9/11) in female patients with 0, 1, 2, 3, 4, and 5 independent predictors, respectively; p < 0.0001]. The five no-reflow predicting variables were admission SBP <100 mmHg, target lesion length >20 mm, collateral circulation 0-1, pre-PCI thrombus score ≥ 4, and IABP use before PCI in female patients with STEMI treated with PPCI.
authors.affiliation: Department of Cardiology, Chinese PLA General Hospital, 100853, Beijing, China.
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
authors.forename: Changhua
authors.initials: C
authors.lastname: Wang
authors.forename: Xinchun
authors.initials: X
authors.lastname: Yang
authors.forename: Lefeng
authors.initials: L
authors.lastname: Wang
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Sun
authors.forename: Hongbin
authors.initials: H
authors.lastname: Liu
authors.forename: Lian
authors.initials: L
authors.lastname: Chen
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001794:Blood Pressure; D016009:Chi-Square Distribution; D002681:China; D003097:Collateral Circulation; D017023:Coronary Angiography; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000150:complications; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome