title: Simple clinical risk score for no-reflow prediction in patients undergoing primary Percutaneous Coronary Intervention with acute STEMI.
abstract: OBJECTIVE
  To identify the STEMI patients at high risk in terms of no-reflow during percutaneous coronary intervention (PCI) with a simple risk score system that can be used before reperfusion.
  
  
  METHODS
  Total 173 patients who had undergone primary or rescue percutaneous coronary intervention following the diagnosis of STEMI, were classified as "no-reflow" developers and "no-reflow" non-developers, during the procedure. The pre-procedural ECGs, laboratory parameters, demographic data, time for the treatment, and the treatment methods were evaluated with univariate analysis. The independent predictors were identified by multivariate logistic regression analysis among the no-reflow risk factors. Using the independent predictors, we developed a simple risk score system proportional to area under the ROC (AUROC) curves.
  
  
  RESULTS
  The independent predictors of "no-reflow" phenomenon were identified as follows: high values of blood glucose at reference; long symptom-onset-to-balloon-time; and low lymphocyte count. The incidence rates of "no-reflow" in patients with low (0-1), moderate (2-3) and high (4-6) risk factors were 13.3%, 40.0%, and 46.7%, respectively. The risk score system demonstrated a good risk prediction between patients with various risk levels of the development of "no-reflow" with a c-statistics of 0.734 (95% CI 0.654-0.814).
  
  
  CONCLUSIONS
  The development of "no-reflow" which is an adverse event in STEMI treatment can be predicted efficiently by simple clinical risk scoring method.
authors.affiliation: Nazile Bilgin Dogan, MD. Department of Cardiology, Menemen State Hospital, Izmir, Turkey.
authors.forename: Nazile Bilgin
authors.initials: NB
authors.lastname: Dogan
authors.affiliation: Ebru Ozpelit, MD. Department of Cardiology, DokuzEylul University Hospital, Izmir, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Ozpelit
authors.affiliation: Selma Akdeniz, MD. Department of Cardiology, AKUT Cardiovascular Hospital, Izmir, Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Akdeniz
authors.affiliation: Muzaffer Bilgin, M.Sc. Department of Biostatistics, Eskisehir Osmangazi University, Eskisehir, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Bilgin
authors.affiliation: Prof. Dr. Nezihi Baris, Professor, Department of Cardiology, DokuzEylul University Hospital, Izmir, Turkey.
authors.forename: Nezihi
authors.initials: N
authors.lastname: Baris
keywords: No-reflow; Percutaneous coronary intervention; Risk score; ST-segment elevation myocardial infarction (STEMI)