Predictive value of admission red cell distribution width-platelet ratio for no-reflow phenomenon in acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
BACKGROUND
The red cell distribution width-platelet ratio (RPR), a novel inflammatory marker is currently used to predict inflammation in chronic diseases. It may be associated with adverse outcomes among artery disease but its prognostic value in ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) has not been fully investigated. There is no data regarding the association between RPR and in-hospital major adverse cardiovascular events (MACEs). This study evaluated the relations between pre-procedural RPR and the in-hospital and long-term outcomes in STEMI patients undergoing primary PCI.


METHODS
This study included 580 STEMI patients (77% men, mean age: 59 ± 12 years). The patients were divided into two groups according to thrombolysis in myocardial infarction (TIMI) flow grades after primary PCI. No-reflow was defined as a post-PCI TIMI flow grade of 0, 1 or 2 (group 1). Angiographic success was defined as TIMI flow grade 3 (group 2).


RESULTS
Whole blood cell count, neutrophil and lymphocyte percentages, red cell distribution width, platecrit, neutrophil-lymphocyte ratio (NLR) and RPR values were higher among patients with no-reflow. On multivariate analysis, pain to balloon time, multivessel disease, TIMI thrombus grade, tirofiban, aspirin, previous coronary artery disease, NLR, platecrit and RPR remained independent predictors of no-reflow after primary PCI. Patients in no-reflow group tended to be higher percent in-hospital MACE, including nonfatal myocardial infarction and cardiovascular mortality compared to the reflow patients.


CONCLUSIONS
Admission NLR, platecrit and RPR are independent correlates of no-reflow and in-hospital MACEs among patients with STEMI undergoing primary PCI.
Turgay
T
Celık
Gulhane Medical Faculty, Dept. of Cardiology, Ankara, Turkey. drsevketb@gmail.com.
Sevket
S
Balta
Mustafa
M
Demır
A Osman
AO
Yıldırım
Mehmet Gungor
MG
Kaya
Cengiz
C
Ozturk
Sait
S
Demırkol
Murat
M
Unlu
Selim
S
Kılıc
İbrahim
İ
Aydın
Atila
A
Iyısoy
D000328:Adult; D000368:Aged; D001792:Blood Platelets; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D004909:Erythrocyte Indices; D004912:Erythrocytes; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D016017:Odds Ratio; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D010976:Platelet Count; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
ST segment elevation myocardial infarction; in-hospital prognosis; neutrophil–lymphocyte ratio; platecrit; primary percutaneous coronary intervention; red cell distribution width–platelet ratio