Risk Prediction Score Of No-reflow Phenomenon In PCI

Objective: To establish a scoring system for predicting the risk of no-reflow in patients with acute myocardial infarction(AMI)during percutaneous coronary intervention(PCI).Method: The clinical history of 121 patients with no reflow and 144 patients with normal blood flow between January 2014 and December 2019 were analyzed retrospectively.Find out the influencing factors of NRP and incorporate them into the binary logistic regression model.predictors of NRP from the model were assigned integer weights based on their coefficients and incorporated into a risk score,and cut off values are used for risk stratification.The discriminant ability of the score was tested by receiver operating characteristic analysis.Results:Smoking index>275(OR=2.394,95%CI:1.382~4.147,P=0.002),Pain to Vascular access time>10h(OR=3.027,95%CI:1.732~5.290,P<0.001),multi vessel lesions(OR=2.439,95%CI:1.326~4.485,P=0.004),preoperative TIMI blood flow ? 2(OR=2.992,95%CI:1.440~6.219,P=0.003)were independent risk factors for no-reflow,and drug intervention(OR=0.532,95%CI:0.291~0.973,P=0.041)was the protective factor for no-reflow.The incidence rates of "no-reflow" in patients with low(0~4)and high(5~10)risk factors were 11.6%and 88.4%,respectively.The risk scoring system has good risk prediction for patients with different levels.The area under the receiver operating characteristic curve of the risk scoring model was 0.741(95%CI:0.681~0.801).Conclusions: The causes of no-reflow phenomenon of coronary artery are complex.A simple scoring system based on the clinical data of PCI patients can quickly determine the risk stratification and provide effective reference for intervention physicians to take comprehensive prevention and control.