EUROPEAN JOURNAL OF
PHARMACEUTICAL AND MEDICAL RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Reviewed Journal for Pharmaceutical, Medical & Biological Sciences

An Official Publication of Society for Advance Healthcare Research (Reg. No. : 01/01/01/31674/16)

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 ISSN 2394-3211

Impact Factor: 6.222

 ICV - 79.57

Abstract

PREDICTORS AND OUTCOMES OF NO-REFLOW PHENOMENON FOLLOWING PRIMARY PERCUTANEOUS INTERVENTION FOR ST ELEVATION MYOCARDIAL INFARCTION

Ahmed A. Rozza*, MD, Yosry Z. Elzohery, MD, Ahmed M. Fahmy, MD, Mohamed A. Abo Ahmed, MD and Mohamed E. Elgizy, M. SC.

ABSTRACT

Objective: After acute myocardial infarction (AMI), the immediate therapeutic goal is to establish patency of the infarct-related artery. The successful restoration of epicardial coronary artery patency, however, does not necessarily translate into improved tissue perfusion. The ‘no-reflow’ phenomenon, characterized by inadequate flow at tissue level despite a reopened epicardial coronary artery after percutaneous coronary intervention. Although uncommon side effects of percutaneous coronary intervention, no-reflow phenomenon is considered a critical complication if not reversed, causes a high rate of mortality and morbidity.[1] Methods: The study population consisted of 120 consecutive patients presented with STEMI and treated with PPCI during the period from the 1st of November 2016 to July 2017 in Al-Azhar Main University Hospital, and the national heart institute (NHI), Giza, Egypt.All patients were subjected to informed consent, detailed history taking, clinical evaluation, ECG analysis and laboratory investigations (including admission CBC, RPG, lipid profile). Door to balloon time computed and given in hours. Coronary angiography (showing the initial TIMI flow) and PCI procedure (whether POBA, BMS, or DES were used, and the occurrence of no reflow phenomenon) were also documented. Patients were put under observation to detect the occurrence of any in-hospital MACE or other hemodynamic complications. Results: The incidence of no reflow was 13.2%, and in hospital MACE was 5%, with cardiac death as the predominant form of in hospital MACE. The group with no reflow or in hospital MACE showed significantly older age, longer door to balloon time, higher levels of admission RPG, N/L ratio, and MPV.Compared to the literature, Egyptian patients had more diabetes mellitus, more dyslipidaemia, longer door to balloon time, than patients studied in Europe, and Japan. Stenting in primary coronary intervention in our country was the usual practice according to ESC guidelines. Conclusion: Older patient age, longer door to balloon time, admission hyperglycemia, higher admission N/L ratio, MPV, longer reperfusion time, elevated level of high sensitive CRP on admission, and markedly elevated levels of CKMB, large thrombus burden LTB , are useful predictive factors for the occurrence of no reflow post PPCI, and/or in hospital MACE.

Keywords: Acute myocardial infarction, No-reflow phenomenon, Percutaneous coronary intervention, Thrombus.


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Google Scholar Indian Science Publications InfoBase Index (In Process) SOCOLAR, China Research Bible, Fuchu, Tokyo. JAPAN International Society for Research activity (ISRA) Scientific Indexing Services (SIS) Polish Scholarly Bibliography Global Impact Factor (GIF) (Under Process) Universal Impact Factor International Scientific Indexing (ISI), UAE Index Copernicus CAS (A Division of American Chemical Society) USA (Under Process) Directory of Open Access Journal (DOAJ, Sweden, in process) UDLedge Science Citation Index CiteFactor Directory Of Research Journal Indexing (DRJI) Indian citation Index (ICI) Journal Index (JI, Under Process) Directory of abstract indexing for Journals (DAIJ) Open Access Journals (Under Process) Impact Factor Services For International Journals (IFSIJ) Cosmos Impact Factor Jour Informatics (Under Process) Eurasian Scientific Journal Index (ESJI) International Innovative Journal Impact Factor (IIJIF) Science Library Index, Dubai, United Arab Emirates Pubmed Database [NLM ID: 101669306] (Under Process) IP Indexing (IP Value 2.40) Web of Science Group (Under Process) Directory of Research Journals Indexing Scholar Article Journal Index (SAJI) International Scientific Indexing ( ISI )