Clinical variables associated with no-reflow after percutaneous coronary intervention in ST-segment elevation myocardial infarction: Secondary analysis of the PERSTEMI I and II study

• Autores: Paredes-Paucar, Cynthia, Custodio-Sanchez, Piero, Chacon Diaz, Manuel, Custodio-Sánchez, Piero, Chacón Diaz, Manuel
• Formato: artículo
• Fecha de Publicación: 2022
• Institución: Instituto Nacional Cardiovascular
• Repositorio: Archivos peruanos de cardiología y cirugía cardiovascular
• Lenguaje: español; inglés
• OAI Identifier: oai:apcyccv.org.pe:article/253
• Enlace del recurso: https://apcyccv.org.pe/index.php/apccc/article/view/253
• Nivel de acceso: acceso abierto
• Materia: Fenómeno de no Reflujo; Infarto de Miocardio con Elevación del ST; Intervención Coronaria Percutánea; Perú; No-Reflow Phenomenon; ST Elevated Myocardial Infarction; Percutaneous Coronary Intervention; Peru

Objective. To determine the clinical factors associated to no-reflow after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) in Peru. Materials and methods. Case - control retrospective study, derived from the PERSTEMI (Peruvian Registry of ST-elevation myocardial infarction) I and II study. Cases (group 1) were those patients who presented no-reflow after PCI, defined by a TIMI flow < 3, and controls (group 2) were those with a TIMI 3 flow after the intervention. Clinical and angiographic variables were compared between both groups, and a multivariate analysis was performed looking for associated factors to no-reflow. Results. We included 75 cases and 304 controls. The incidence of no-reflow was 19.8%. There was a higher frequency of no-reflow in patients with primary PCI compared to the pharmacoinvasive strategy, in patients with one-vessel disease and in those with TIMI 0 before PCI. In-hospital mortality and heart failure were higher in patients with no-reflow (21.3% vs. 2.9% and 45.3% vs. 16.5, respectively; p<0.001). After the multivariate analysis, the ischemia time > 12 hours, Killip Kimball (KK) > I, TIMI 0 before PCI, and one-vessel disease were the factors significantly associated with no-reflow after PCI. Conclusions. The ischemia time greater than 12 hours, the highest KK score, the presence of an occluded culprit artery (TIMI 0) before PCI and an one-vessel disease, were factors independently associated to no-reflow in patients with STEMI in Peru.