Link between aortic valve sclerosis and myocardial no-reflow in ST-segment elevation myocardial infarction.
OBJECTIVE
The"no-reflow" phenomenon is associated with a worse prognosis at follow-up for patients with acute ST-segment elevation myocardial infarction (STEMI). Predicting and preventing no-reflow is therefore a crucial step in improving the prognosis of STEMI patients. The purpose of this study was to investigate the association between aortic valve sclerosis (AVS) and myocardial no-reflow in patients with STEMI.


METHODS
Patients with a first-time diagnosis of STEMI were enrolled consecutively. No-reflow was defined as a final TIMI 3 flow with a myocardial blush of grade < 2, temporary epicardial coronary no-reflow, and distal coronary occlusion. AVS was defined by echocardiography as thickening and calcification of the normal trileaflet aortic valve without obstruction to the left ventricular outflow.


RESULTS
No-reflow developed in 41 patients. In univariate analysis, age, male gender, smoking, culprit lesion Syntax score (SX score), and hypertension were significantly associated with no-reflow. Multivariate binary logistic regression analyses demonstrated age [95 % confidence interval (CI), 1.024-1.096; p=0.001), AVS (95 % CI, 1.002-1.100; p=0.039], culprit lesion SX score (95 % CI, 1.08-1.021 p=0.008), and symptom-to-balloon time (95 % CI, 1.020-1.097; p=0.002) as independent determinants of myocardial no-reflow.


CONCLUSIONS
AVS was significantly and independently associated with myocardial no-reflow in STEMI patients.
Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey, l.korkmaz@yahoo.com.
L
L
Korkmaz
H
H
Erkan
M T
MT
Ağaç
E
E
Pelit
H
H
Bektas
Z
Z
Acar
I
I
Gurbak
F
F
Kara
Ş
Ş
Çelik
D017677:Age Distribution; D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012598:Sclerosis; D017678:Sex Distribution; D014421:Turkey / Q000453:epidemiology