Relative Factors For Angiographic No Reflow Phenomenon After Primary Percutaneous Coronary Intervention With Acute Myocardial Infarction

Objective To elucidate the relative factors for angiogrphic no reflow phenomenon after primary percutaneous coronary intervention (PCI)with acute myocardial infarction (AMI).Methods There were two hundreds and eighty patients of acute myocardial infarction in there seach.All cases were examined by coronary artery angiograghic semiquantitative(CAG) before and after primary percutaneous coronary intervention therapy. Thirty six patients were with angiogrphic no reflow phenomenon which are define as coronary antergrade flow below TIMI 3 class after primary PCI ,and forty five patients were regard as normal flow group randomized from 244 with coronary antergrade flow TIMI 3 class .Two groups were investigated and contrasted by the following items: age,sex,smoking,hypertension,hyperlipemia,diabetes mellitus,enzyme peakvalue, ΣSTI, compensatory circulation,the TIMI 0 class of blood flow before emergent PCI,the time from symptom onset to reflow,the preinfaction agina, Killip class>I,the number of Q waves on electrocardiogam, wall motion score and IRA,the status of the coronary artery,thrombus in coronary artery and the status of chioced stents. Multiple logistic regression analysis was used to identify independent relative factors of the no reflow phenomenon.Results Incidence of the no reflow phenomenon was 12.9% in all 280 patients.. Univariate analysis showed that hyperlipemia,diabetes mellitus,enzyme peakvalue, Σ STI, the TIMI 0 class of blood flow,the time from symptom onset to reflow,the preinfaction agina, Killip class>I,the number of Q waves on electrocardiogam, wall motion score were related to the no reflow phenomenon.However,multipal Logistic regression analysis indicated mat Σ STI after PCI, the TIMI 0 class of blood flow before emergent PCI, the time from symptom onset to reflow,the preinfaction agina, Killip class>I,the number of Q waves on electrocardiogam were the relative factors of the no reflow phenomenon.Conclusions ΣSTI after PCI, the TIMI 0 class of blood flow before emergent PCI,the time from symptom onset to reflow, Killip class>I,the number of Q waves on electrocardiogam were the relative risk factors of the no reflow phenomenon.These illustrate that large area of myocardial necrosis,the severely myocardial damage , heart failure,and the long time from the symptom onset to reflow can promote the angiogrphic no reflow phenomenon. Preinfaction agina seems to be the safety factor that attenuates the angiogrphic no reflow phenomenon.However, risk factors of coronary heart disease , IRA,the status of coronary artery andthe stents have no relation to no reflow phenomenon.