Long-Term Clinical Outcomes of Transient and Persistent No Reflow Phenomena following Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

被引：27

作者：

Kim, Min Chul ^{[1
]}

Cho, Jae Yeong ^{[1
]}

Jeong, Hae Chang ^{[1
]}

Lee, Ki Hong ^{[1
]}

Park, Keun Ho ^{[1
]}

Sim, Doo Sun ^{[1
]}

Yoon, Nam Sik ^{[1
]}

Youn, Hyun Joo ^{[1
]}

Kim, Kye Hun ^{[1
]}

Hong, Young Joon ^{[1
]}

Park, Hyung Wook ^{[1
]}

Kim, Ju Han ^{[1
]}

Jeong, Myung Ho ^{[1
]}

Cho, Jeong Gwan ^{[1
]}

Park, Jong Chun ^{[1
]}

Seung, Ki-Bae ^{[2
]}

Chang, Kiyuk ^{[2
]}

Ahn, Youngkeun ^{[1
]}

机构：

[1] Chonnam Natl Univ, Sch Med, Chonnam Natl Univ Hosp, Dept Cardiol, Gwangju, South Korea

[2] Catholic Univ, Sch Med, Seoul St Marys Hosp, Dept Cardiol, Seoul, South Korea

来源：

KOREAN CIRCULATION JOURNAL | 2016年 / 46卷 / 04期

基金：

新加坡国家研究基金会;

关键词：

Myocardial infarction; No-reflow phenomenon; Percutaneous coronary interventions; INTRAVASCULAR ULTRASOUND; PRIMARY ANGIOPLASTY; PROGNOSTIC VALUE; ELUTING STENTS; IMPACT; REPERFUSION; PREDICTORS; TRIALS;

D O I：

10.4070/kcj.2016.46.4.490

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 and Methods: 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.

引用

页码：490 / 498

页数：9