Related Risk Factors Of No-reflow Phenomenon Of IRA After Emergency PCI In STEMI Patients

Objective: To explore and analysis the related risk factors of no-reflowphenomenon of IRA after percutaneous cornory intervention (PCI) inST-segment elevation acute myocardial infarction (STEMI) patients，so as toprovide the evidence for prevention and treatment no-reflow phenomenonafter PCI.Methods:360patients diagnosed with acute ST-segment elevationmyocardial infarction in the first hospital affiliated to Soochow universityfrom June2010to June2013were selected consecutively. All of the patientsundergoing emergency PCI, According to infarction related artery(IRA)TIMI(Thrombolysis In Myocardial Infarction) grade standards divided allpatients into two groups:290cases in successful reperfusion group（TIMI3）and70cases in no reflow group（TIMI≤2）. Clinical, coronary arteriographyand PCI information dates were collected. The SPASS17.0statisticalsoftware was used to analysis the related risk factors of no-reflowphenomenon.Results:1.360patients with STEMI after emergency PCI and70cases had no-reflow phenomenon of IRA, and no-reflow incidence rate was 19.44%2.Single factor analysis showed that sex, body mass index, drinkinghistory, history of hypertension, diabetes, hyperlipidemia disease, anginapectoris, before infarction angina, preoperative blood pressure, heart rate,white blood cell count, mononuclear cell count, average red blood cell count,hemoglobin, platelet volume, total cholesterol, uric acid, urea nitrogen,albumin, hypersensitive c-reactive protein and low-density lipoproteincholesterol (LDL-C), triglycerides, glutamic pyruvic transaminase, glutamicoxalacetic transaminase, IRA, lesion location were no significant differencebetween the two groups (P>0.05). while age, smoking history, ST segmentfell more than50%, the time from symptoms began to PCI, preoperativetroponin, preoperative creatine kinase MB(CK-MB), stress blood glucose,creatinine, blood platelet count and high density lipoprotein cholesterol(HDL-C), myocardial infarction cardiac function（Killip） grade more than II,reperfusion method had significant differences between the two groups (P <0.05).3. Multiple Logistic regression analysis showed that the plateletcount, stress blood glucose, preoperative troponin and CK-MB, ST segmentfalling more than50%after PCI, the time from symptoms began to PCI,reperfusion method were independent risk factors of no-reflow (P <0.05).Conclusion: No-reflow incidence rate was19.44%. Platelet count, stress blood glucose, preoperative troponin and CK-MB, the time from symptomsbegan to PCI, ST segment recover slow, reperfusion method wereindependent risk factors suggesting no-reflow phenomenon after emergencyPCI.