title: [The impact of pre-primary percutaneous coronary intervention β blocker use on the no-reflow phenomenon in patients with acute myocardial infarction].
abstract: OBJECTIVE
  To investigate the impact of pre-primary percutaneous coronary intervention (PCI) β blocker use on the development of no-reflow in ST-segment elevation myocardial infarction (STEMI) patients post PCI.
  
  
  METHODS
  We retrospectively evaluated 1 615 outpatients with STEMI who underwent primary primary PCI with in 12 hours from symptom onset admitted to Beijing Anzhen Hospital and Chinese people's liberation army general hospital from January 2007 to June 2011. The study population was divided into the following 2 groups: β blocker group (pretreatment with β blockers ≥ one month before admission, n = 257) and non-β blockers group (pretreatment with β blockers < one month before admission or had no β blocker, n = 1 358). No-reflow was defined as TIMI grade < 3 in last imaging of coronary artery after stenting. Multivariable logistic regression analyses were used to identify independent predictors for the no-reflow after primary PCI.
  
  
  RESULTS
  Incidence of the no-reflow was significantly lower in the β blocker group than in non-β blockers group (13.6% (35/257) vs. 21.2% (289/1 358), P = 0.017). Multivariable logistic regression analysis revealed that pre-PCI β blocker use was a protective predictor of the no-reflow (OR = 0.594, 95%CI:0.394-0.893, P = 0.012), while age ≥ 55 years old (OR = 2.734, 95%CI:1.959-3.817, P < 0.001), high neutrophil count (OR = 1.257, 95%CI: 1.169-1.351, P < 0.001), admission plasma glucose (OR = 1.060, 95%CI:1.018-1.103, P = 0.004), Killip classes IV (OR = 3.383, 95%CI:1.924-5.948, P < 0.001) and reperfusion time ≥ 4 h(OR = 1.503, 95%CI:1.124-2.009, P = 0.006) were risk factors for the development of no-reflow post PCI.
  
  
  CONCLUSIONS
  Previous long term β blockers use before STEMI is associated with lower incidence of no-reflow in patients with STEMI treated with primary PCI.
authors.affiliation: Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Jinwen
authors.initials: J
authors.lastname: Wang
authors.affiliation: Email: cyundai@medmail.com.cn.
authors.forename: Yundai
authors.initials: Y
authors.lastname: Chen
authors.forename: Changhua
authors.initials: C
authors.lastname: Wang
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D054318:No-Reflow Phenomenon; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents
chemical_list: D000319:Adrenergic beta-Antagonists