Analysis Of Related Factors Of No Reflow After Primary Percutaneous Coronary Intervention In Patients With Early-onset Acute ST Segment Elevation Myocardial Infarction

Object:This article analyzes the risk factors of no reflow after direct PCI in the patient group of premature acute myocardial infarction,and clarifies the risk factors of no reflow after PCI in this special population.A total of 464 patients with acute myocardial infarction and direct PCI were collected from August 2018 to July 2019 in Jilin University First Hospital.According to the standard of thrombolytic flow classification(TIMI)of acute myocardial infarction during PCI(no reflow for TIMI ≤ 2 and normal flow for TIMI 3),the patients were divided into two groups,117 patients in no reflow group and 347 patients in normal flow group.By comparing the basic clinical data of the two groups of patients,the characteristics of coronary angiography,relevant biochemical indicators,etc.,the risk factors of no reflow in patients with early-onset STEMI after PCI were analyzed.Using x2 test,Mann Whitney U test and other statistical analysis methods,the relevant variables with statistical significance were obtained;in the single factor variables with statistical significance,logistic regression analysis was used to screen the independent predictors of no reflow in patients with premature acute ST segment elevation myocardial infarction after PCI,and finally the best critical point of the corresponding continuous variables was obtained.Result:By comparing the related factors of normal blood flow and no-reflow patients,using X2 test,Mann-Whitney U test,T test and other analysis,we found that the time from onset to vascular opening,body mass index(BMI),Compared with the normal blood flow group,the white blood cell count,neutrophil count,mean platelet volume,neutrophil to lymphocyte ratio(NLR)were significantly different(P<0.05).Logistic regression analysis found that the time from onset to vascular opening,body mass index,white blood cell count,neutrophil count,neutrophil to lymphocyte ratio were independent risk factors for no reflow and were related to cardiovascular adverse events.Conclusion:1、Time from onset of myocardial infarction to vessel opening,body mass index,white blood cell count,neutrophil count,mean platelet volume and neutrophil lymphocyte ratio were independent risk factors for no reflow after PCI in patients with premature acute ST segment elevation myocardial infarction.2、The time from onset of myocardial infarction to vessel opening,white blood cell count,neutrophil count,mean platelet volume,neutrophil lymphocyte ratio and body mass index were the independent risk factors for no reflow after PCI in STEMI patients.The optimal cut-off values were6.7h[OR=1.006,95%CI(1.003-1.008,P<0.001)]10.59*109/L[OR=2.638,95%(2.124-3.276),P=0.015]、8.77*109/L[OR=2.717,95%CI(2.117-3.391),P=0.008]、10.85 f L[OR=1.123,95%CI(1.040-1.211),P=0.037]、5.15[OR=1.302,95%CI(1.221-1.389),P<0.001]、24.05Kg/m2[OR=1.161,95%CI(1.080-1.248),P=0.031].