The impact of pre-primary percutaneous coronary intervention β blocker use on the no-reflow phenomenon in patients with acute myocardial infarction / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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%CI0.394-0.893, P = 0.012), while age ≥ 55 years old (OR = 2.734, 95%CI1.959-3.817, 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%CI1.018-1.103, P = 0.004), Killip classes IV (OR = 3.383, 95%CI1.924-5.948, P < 0.001) and reperfusion time ≥ 4 h(OR = 1.503, 95%CI1.124-2.009, P = 0.006) were risk factors for the development of no-reflow post PCI.</p><p><b>CONCLUSION</b>Previous long term β blockers use before STEMI is associated with lower incidence of no-reflow in patients with STEMI treated with primary PCI.</p>