title: Left circumflex coronary artery is protected against no-reflow phenomenon following percutaneous coronary intervention for coronary artery disease.
abstract: Despite the positive impact of percutaneous coronary intervention (PCI) on reducing mortality, a small percentage of patients experience poor myocardial reperfusion following PCI. However, factors associated with no-reflow remain unclear. We investigated clinical factors associated with no-reflow following PCI for coronary artery disease (CAD). We retrospectively analyzed 1622 consecutive CAD patients who underwent PCI over a 5-year period at our institution. Patients were divided into two groups according to the presence (n = 31) or absence (n = 1591) of no-reflow, defined as Thrombolysis in Myocardial Infarction flow grade <3 after PCI. No significant differences in patient characteristics or PCI strategy were seen between the no-reflow and normal flow groups. The incidence of no-reflow was significantly lower in the left circumflex artery (LCx) than in the left anterior descending artery (LAD) (P = 0.0015), with no differences in characteristics or PCI strategy between these two target vessels. Multivariate analysis revealed that involvement of the LCx was an independent protective factor against no-reflow (odds ratio 0.14, 95 % confidence interval 0.02-0.98, P = 0.044). In conclusion, LCx as the target vessel was protective against no-reflow compared with LAD following PCI for CAD. Our results suggest that embolic protection devices may be unnecessary in CAD patients with involvement of LCx.
authors.affiliation: Department of Cardiology, National Hospital Organization, Saitama Hospital, Saitama, Japan, umc-nagai@hotmail.co.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Nagai
authors.forename: Takuro
authors.initials: T
authors.lastname: Hirano
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tsunoda
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Hosaka
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kishino
authors.forename: Takaharu
authors.initials: T
authors.lastname: Katayama
authors.forename: Keisuke
authors.initials: K
authors.lastname: Matsumura
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyagawa
authors.forename: Shun
authors.initials: S
authors.lastname: Kohsaka
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Anzai
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054318:No-Reflow Phenomenon / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome