Assessment of the Clinical and Procedural Predictive Factors ofNo-Reflow Phenomenon Following Primary Percutaneous CoronaryIntervention

AbstractBackground: Angiographic no-reflow phenomenon, areduced coronary antegrade flow (TIMI grade <-2) withoutmechanical obstruction after recanalization, predicts poor LVfunctional recovery and survival in the early phase of STEMI.Although predisposing factors phenom-enon were investigated, there is little data about clinical andprocedural predictors this phenomenon.Aim Study: The aim study was to evaluate theclinical procedural predictive phe-nomenon following primary PCI.Patients Methods: present conductedon 145 patients admitted with STEMI treated 1ryPCI at Cardiovascular Medicine Department, Tanta UniversityHospitals within 6 months from June 2016 December 2016.Patients divided into 2 groups according no-reflowphenomenon. Group I: 29 no reflow phenomenon.Group II: 116 without phenomenon. Allpatients subjected an informed consent, history takingincluding personal history, risk including Hypertension (HTN), Diabetes Mellitus (DM), smoking, renal impairment.family premature artery disease, pastmedical prior Myocardial Infarction (MI), Percuta-neous Coronary Intervention (PCI) or Artery BypassGraft (CABG), medications examinationincluding vital signs, Body Mass Index (BMI), signs heartfailure/hemodynamic instability Killip classifi-cation, co-morbidities renal/hepatic insuf-ficiency, diabetes. Local cardiac examination, twelve leadssurface ECG, echocardiography, blood sampling includingserum biomarkers, complete count, lipid profile (total cholesterol, HDL, LDL, triglycerides), random bloodsugar on admission, serum urea & creatinine admission.Patients diagnostic angiographyand PCI.Results: demonstrated that a signif-icant association between angiographic old age, female gender, DM, MI, increased timeto reperfusion, higher class, decreased LV ejectionfraction, CKMB, glucose,increased creatinine, use inotropes, initial TIMIflow 0, high thrombus burden stenting ballonpredilatation.Conclusion: occurrence phenomenonafter PCI can be predicted using simple clinical,laboratory, features which includeold increasedtime ballonpredilatation.