The Value Of The Pre-PCI ECG Parameters In Predicting The Myocardial Reperfusion Level After Emergency PCI

Background: No-reflow phenomenon appears in lots of patients underwent emergency percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), and predicts poor long-term prognosis. It has become one of the tough problems in the era of reperfusion therapy. The myocardial reperfusion level after emergency PCI may decide whether the PCI should be performed, and provides help to the prevention and treatment of no-reflow phenomenon. The ECG parameters predicting the myocardial reperfusion level may be helpful for the selection of appropriate patients for emergency PCI and the preventive measures for no-reflow phenomenon.Objective: To investigate whether the ECG parameters can be used to predict the myocardial reperfusion level after emergency PCI.Method: Clinical and angiographic data of 125 patients who underwent primary PCI for ST-segment elevation myocardial infarction (STEMI) were retrospectively analyzed. The relationship between the pre-PCI ECG parameters and the myocardial reperfusion level was analyzed.The materials were recorded as the follows: (1) Age, gender, diagnosis, AMI onset time. (2) Initial ECG parameters, including QRS score (Selvester 32-Point QRS Scoring System), ST-segment elevation pattern (Type A, Type B, Type C), number of leads with ST elevation andΣST elevation. (3) Segment of infarct-related artery. (4) Patency of infarct-related artery, TIMI flow grade, CTFC (corrected timi frame counts), myocardial blush grade, Rentrop collateral grade and reperfusion arrhythmias.All the data was analyzed with SPSS16.0 statistical software. P<0.05 was considered statistically significant. The independent risk factors of no-reflow were selected by multiple logistic regression analysis.Results: (1) ST-segment elevation pattern was statistically significant between no-reflow group and reflow group(p<0.05). (2) Multiple logistic regression analysis demonstrated that ST-segment elevation pattern (Type C) and Segment of infarct-related artery were the independent risk factors for no-reflow phenomenon after primary PCI. (3) The onset time was statistically significant between reperfusion arrhythmias group and no-reperfusion arrhythmias group(p<0.05).Conclusion: ST-segment elevation pattern (Type C) can predict coronary no-reflow phenomenon after primary PCI in patients with STEMI.