The Risk Factors Analysis Of No-reflow Phenomenon In Patients With STEMI Undergoing PCI

objective To analyse relative risk factors of no-reflow phenomenon in patients with ST-segmentelevationmyocardial infarction(STEMI)undergoing PCI(Percutaneous Coronary Intervention,PCI),to provide reference for preventing no-reflow phenomenon before PCI.Methods We admitted 70 patients with STEMI undergoing PCI from the onset of symptoms at the first affiliated Hospital of University of South China from January 2016 and January 2018.The patients were divided into normal-reflow group and no-reflow group,based on the thrombolysis in myocardial infarction(TIMI)flow grade.Collected basic clinical data,related biochemical indicators,angiography results and operative data of all selected patients and detected HMGB1 and NO in serum by ELISA before PCI.Analyzed basic clinical data,related biochemical indicators,angiography results,operative data,level of HMGB1 and NO in serum.Logistic regression model was performed toanalyze the independent predictors of no-reflow in patients with STEMI undergoing PCI.Results 1.There were no statistical significance between two groups in gender,family history of CHD,history of old myocardial infarction,hypertension,and systolic or diastolicpressure before PCI(p>0.05).Compared with control group,there were advanced age,higher rate of history of smoking and history of diabetes mellitus,and long time of reperfusion in patients in no-reflow group.The differences were statistically significant(p<0.05).2.Compared no-reflow group with control group,the infarct-related artery,location of lesion and diameter of target vessels of all patients has no statistics significance(p>0.05).Compared with control group,there were higher thrombus burden and longer length of target vessels in no-reflow group,and the differences were statistically significant(p<0.05).3.Compared no-reflow group with control group,the NLR,HDL-C,PLT and TG of all patients has no statistical significance(p>0.05).Compared with control group,there were higher serum concentration of HMGB1,CRP,LDL-C and TC,lower serum concentration of NO,bigger MPV of patients in no-reflow group,and the differences were statistically significant(p<0.05).4.Multivariate logistic regression model shows that the reperfusion time(OR:1.22;95%CI:1.14~1.24;p=0.004),degree of thrombus burden(OR:2.02;95%CI:1.50~2.77;p=0.037),length of target vessels(OR:1.32;95%CI:1.03~1.84;p=0.006),HMGB1(OR:1.40;95%CI:1.08~2.90;p=0.018),CRP(OR:1.46;95%CI:1.24~1.89;p=0.004),MPV(OR:1.32;95%CI:1.24~2.06;p=0.032),TC(OR:1.38;95%CI:1.04~2.56;p=0.028)and NO(OR:1.62;95%CI:1.48~1.72; p=0.008)were risk factors of no-reflow phenomenon in patients with STEMI after PCI.Conclusion: Reperfusion time,degree of thrombus burden,length of target vessels,HMGB1,CRP,TC,NO and MPVcan be respectively independent predictors of no-reflow phenomenon in patients with STEMI undergoing PCI.