Effect Of Early Unfractionated Heparin Pretreatment On No Reflow In Primary Percutaneous Coronary Intervention

Objective:This study was designed to investigate the effect of early unfractionated heparin pretreatment prior to primary percutaneous coronary intervention(PPCI)on the incidence of no-reflow in patients with ST-segment elevation myocardial infarction(STEMI).Methods: 308 consecutive patients with STEMI and undergoing PPCI from January 2015 to December 2017 in Fuzhou General Hospital were enrolled.The time interval of first unfractionated heparin use to balloon dilatation(H-to-B)was recorded.The cases were divided into two groups according to the median of H-to-B time,the early treatment group with a median time less than 19 minutes(n = 154)and the routine treatment group with a median time more than 19 minutes(n = 154).The TIMI blood stream grade and corrected TIMI frame count(cTFC)immediately after PPCI was observed and recorded.No reflow after PPCI was defined as a TIMI grade ? 3,or a TIMI-3 flow with a cTFC > 40 frames.Results: No significant difference was observed in the baseline clinical and laboratory characteristics between groups.There was no statistical difference between the two groups except nicorandil.There were significant difference in the TIMI grade and cTFC between the two groups(P?0.05).The incidence of no reflow was 21.4% in the early treatment group and 32.5% in the the routine treatment group,respectively(P?0.05).In the multivariate logistic regression model,early unfractionated heparin pretreatment was associated with lower incidence of no reflow.Conclusion: The early unfractionated heparin pretreatment can significantly reduce the incidence of no reflow during PPCI.