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
in English
| WPRIM (Western Pacific)
| ID: wpr-227804
Responsible library:
WPRO
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.
Full text:
Available
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cardiovascular Disease
/
Ischemic Heart Disease
/
Other circulatory Diseases
Database:
WPRIM (Western Pacific)
Main subject:
Thrombosis
/
Stents
/
Incidence
/
Follow-Up Studies
/
Mortality
/
No-Reflow Phenomenon
/
Percutaneous Coronary Intervention
/
Heart Failure
/
Myocardial Infarction
Type of study:
Controlled clinical trial
/
Incidence study
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Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Korean Circulation Journal
Year:
2016
Document type:
Article