Study On Risk Factors Of No-reflow In Emergency Percutaneous Coronary Intervention

Objective To investigate the risk factors for no-reflow in percutaneous coronary intervention(PCI)in emergency department.Methods A total of 198 patients with STEMI who were given emergency PCI within 12 hours were enrolled in this study.Their clinical,radiographic and interventional data were collected.According to myocardial infarction(TIMI)classification and TIMI frame correction,patients with PCI were divided into normal blood flow group and no-reflow group.The differences of basic clinical data,radiographic findings and surgical data between the two groups were compared.Risk factors for no-reflow occurred in emergency PCI during STEMI were analyzed.Results A total of 48 indicators were included in the study.Univariate analysis revealed that neutrophil,peak-CK,thrombus burden,thrombus aspiration,and IABP pump implantation were associated with no-reflow during emergency PCI(P<0.05).Multivariable logistic regression model suggested that thrombus aspiration(P=0.041,OR=0.590,95%CI:0.243-0.842)and implanted IABP pump(P=0.001,OR=0.310,95%CI: 0.136-0.338)No reflow occurs during protection.Hypertension(P=0.04,OR=1.48),diabetes(P=0.03,OR=1.55)and thrombus burden had a synergistic effect,significantly increasing the incidence of no-reflow.Conclusions Thrombus aspiration and implantation of IABP pump can reduce the occurrence of non reflow and reduce the incidence of adverse cardiovascular events.Diabetes and hypertension have high risk of non reflow in the cases of STEMI combined with thrombus load.The risk factors of coronary heart disease such as age,smoking,hyperlipidemia and other coronary heart disease are associated with no reflow.