Predictive value of coagulation state on angiographic no-reflow during percutaneous coronary intervention for patients with acute myocardial infarction / 实用医学杂志

ABSTRACT

Objective To investigate the predictive value of coagulation state on the occurrence of no-reflow phenomenon after primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods A total of 187 consecutive patients with the first AMI underwent PCI within 12h post-onset of symptom. The clinical features and angiographic findings were collected. According to the thrombolysis in myocardial infarction (TIMI) flow grade with related artery and myocardial blush grade(MBG), the patients were divided into the no-reflow group (TIMI ≤ 2, or MBG ≤ 1) and the normal reflow group. Blood samples were taken immediately on admission before coronary angiography. The levels of plasma von Willebrand factor(vWF), P-selectin(Ps) and Tissue factor(TF) were measured by enzyme-linked immunosorbent assay. Results 23.5%patients of 187 patients developed the no-reflow phenomenon. The plasma level of vWF and Ps and TF were (4 574 ± 1 677) U/L and (16.8 ± 5.1) ng/mL and (283 ± 81) ng/L in the no-reflow group, and (4 074 ± 1 063) U/L and (14.8 ± 4.2) ng/mL and (254 ± 54) ng/L in the normal group, with significant differences (P = 0.020, 0.010 and 0.007, respectively). The hypercoagulation patients in the no-reflow group were much more than patients in the normal reflow group (P = 0.003). Multivariate stepwise logistic regression analysis revealed that hypercoagulation was independent predictor of no-reflow phenomenon ( OR = 2 . 361 , 95%CI 1 . 083 ~ 5 . 148 , P = 0.031). Conclusion The high levels of plasma vWF, Ps and TF present the evidences of hypercoagulation, which might imply the development of no-reflow after PCI.