title: Mild to Moderate Renal Impairment Is Associated With No-Reflow Phenomenon After Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction.
abstract: We investigated whether admission estimated glomerular filtration rate (eGFR) values are associated with no-reflow phenomenon in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Patients (n = 673; 59 ± 13 years; 77.1% men) were stratified into 3 groups according to eGFR at admission: normal renal function (eGFR ≥ 90 mL/min/1.73 m2), mild renal impairment (eGFR 60-89 mL/min/1.73 m2), and moderate renal impairment (eGFR 30-59 mL/min/1.73 m2). No-reflow phenomenon was defined as thrombolysis in myocardial infarction flow grade <3 after pPCI. The rate of no-reflow gradually increased from the normal renal function group to the moderate impaired renal function group (P < .001). Multivariate analysis showed that eGFR (odds ratio [OR] 0.942, P < .001), Killip ≥2 class (OR 3.968, P = .008), left ventricular ejection fraction (OR 0.959, P = .034), and early patency of infarct vessel (OR 0.186, P < .001) were independent predictors of no-reflow phenomenon. Mild to moderate renal impairment at admission is independently associated with no-reflow phenomenon after pPCI.
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey alpkurtul@yahoo.com.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kurtul
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Sani Namik
authors.initials: SN
authors.lastname: Murat
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlioglues
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Duran
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim Etem
authors.initials: IE
authors.lastname: Celik
authors.affiliation: Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Kilic
mesh_terms: D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D062645:Percutaneous Coronary Intervention; D051437:Renal Insufficiency / Q000209:etiology* / Q000503:physiopathology
chemical_list: D015415:Biomarkers
keywords: acute myocardial infarction; estimated glomerular filtration rate; no-reflow phenomenon; primary percutaneous coronary intervention