Long-Term Clinical Outcomes of Transient and Persistent No Reflow Phenomena following Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
Korean Circulation Journal
;
: 490-498, 2016.
Article
Dans Anglais
| WPRIM
| ID: wpr-227804
ABSTRACT
BACKGROUND AND OBJECTIVES:
There is limited information on the transient or persistent no reflow phenomenon in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). SUBJECTS ANDMETHODS:
The study analyzed 4329 patients with AMI from a Korean multicenter registry who underwent PCI using coronary stents (2668 ST-elevation and 1661 non-ST-elevation myocardial infarction [MI] patients) 4071 patients without any no reflow, 213 with transient no reflow (no reflow with final thrombolysis in myocardial infarction [TIMI] flow grade 3), and 45 with persistent no reflow (no reflow with final TIMI flow grade≤2). The primary endpoint was all-cause mortality during 3-year follow-up. We also analyzed the incidence of cardiac mortality, non-fatal MI, re-hospitalization due to heart failure, target vessel revascularization, and stent thrombosis.RESULTS:
The persistent no reflow group was associated with higher all-cause mortality (hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.08-3.65, p=0.028) and cardiac mortality (HR 3.28, 95% CI 1.54-6.95, p=0.002) compared with the normal reflow group. Transient no reflow increased all-cause mortality only when compared with normal reflow group (HR 1.58, 95% CI 1.11-2.24, p=0.010). When comparing transient and persistent no reflow, persistent no reflow was associated with increased all-cause mortality (46.7 vs. 24.4%, log rank p=0.033).CONCLUSION:
The persistent no reflow phenomenon was associated with a poor in-hospital outcome and increased long-term mortality mainly driven by increased cardiac mortality compared to the transient no reflow phenomenon or normal reflow.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Thrombose
/
Endoprothèses
/
Incidence
/
Études de suivi
/
Mortalité
/
Phénomène de non reperfusion
/
Intervention coronarienne percutanée
/
Défaillance cardiaque
/
Infarctus du myocarde
Type d'étude:
Essai clinique contrôlé
/
Etude d'incidence
/
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Korean Circulation Journal
Année:
2016
Type:
Article
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