Clinical Analysis Of No Reflow Phenomenon In Post-Percutaneous Coronary Intervention Patients 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: 489 acute myocardial infarction patients performed emergency PCI were study objective, who were divided into no-flow group and normal flow group according to infarction related artery TIMI flow grades. There are 37 patients in no-flow group, drawing 50 patients in other 452 normal flow patients randomly as normal flow group. The sex, age, smoking history, diabetic history, hypertension, hyperlipemia, coronary artery disease family history and angina pectoris history before infarction were observed to determine cardiac functional grading (Killip grading). Electrocardiograms, leucocyte counts, creatine phosphokinase isoenzyme (CK-MB), troponin I(cTnI), the time of coronary artery reperfusion, the pathological characteristic of coronary arteriongraphy, the diameter, length, maximum distension tension of stents and the diameter, distension tension, times of distension of balloon were compared in two groups patients.Results: In this study of 489 patients, no-flow occurred- to 37 patients, the accidence rate of 7.56%. There is no significant difference in average age, sex, complicating smoking history, hypertension, diabetic, coronary heart disease family, the site of myocardial infarction, the lesion branches of coronary, culprit vessel site, spasmodism and secret compartment pathological changes (P>0.05). There was dramatic difference in two groups in hyperlipemia, angina pectoris history before infarction, heart function Killip≥2 grading, average lencocyte count, CK-MB, cTnI, the time of coronary artery reperfusion, culprit vessel complete occlusion and thrombus pathological changes (P<0.05). At the same time there was no significant difference between in the diameter, length, maximum distension tension of stents and the diameter, distension tension, times of distension of balloon applied in operation(P>0.05). There was notable difference between two groups in the times of balloon distension (P<0.05).Conclusion: No reflow phenomenon after PCI in AMI is relate with factors as below: hyperlipemia, angina pectoris history before infarction, high heart function on admission, high WBC count, high level of CK-MB and troponin-I, culprit vessel complete occlusion and thrombus pathological changes, long the time of coronary artery reperfusion and increase the times of balloon distension.but the average age, sex, complicating smoking history, hypertension, diabetic, coronary heart disease family, the site of myocardial infarction, the lesion branches of coronary, culprit vessel site and spasmodism, secret compartment pathological changes, the status of stents and the diameter, distension tension of balloon applied in operation have no relation to no reflow phenomenon.