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Bessonov E.Yu.

Alexandrovskaya Hospital

Shishkevich A.N.

Kirov Military Medical Academy;
Mechnikov Northwestern State Medical University

Mikhailov S.S.

Kirov Military Medical Academy;
Mechnikov Northwestern State Medical University

Kravchuk V.N.

Kirov Military Medical Academy;
Mechnikov Northwestern State Medical University

Prediction of no-reflow phenomenon in endovascular treatment of patients with acute ST segment elevation myocardial infarction

Authors:

Bessonov E.Yu., Shishkevich A.N., Mikhailov S.S., Kravchuk V.N.

More about the authors

Journal: Russian Cardiology Bulletin. 2024;19(4): 52‑58

DOI: 10.17116/Cardiobulletin20241904152

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To cite this article:

Bessonov EYu, Shishkevich AN, Mikhailov SS, Kravchuk VN. Prediction of no-reflow phenomenon in endovascular treatment of patients with acute ST segment elevation myocardial infarction. Russian Cardiology Bulletin. 2024;19(4):52‑58. (In Russ.)
https://doi.org/10.17116/Cardiobulletin20241904152

 
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No-reflow phenomenon is common in patients with ST-segment elevation myocardial infarction (STEMI) undergoing coronary artery stenting. There is still no generally accepted risk stratification model for these patients.

OBJECTIVE

To identify predictors and regression model for no-reflow phenomenon in patients with STEMI.

MATERIAL AND METHODS

A retrospective study included 143 STEMI patients who underwent infarct-related artery stenting. We estimated predictors of no-reflow phenomenon and developed appropriate prognostic model. The control group of 50 people tested performance of the model.

RESULTS

Preoperative TIMI grade of antegrade blood flow < 0—1, TIMI thrombus grade 4—5, structure of coronary arteries, leukocytosis, neutrophilia, serum glucose, period between painful attack and percutaneous coronary intervention, as well as previous diabetes mellitus are factors influencing the likelihood of no-reflow phenomenon. The mathematical model has high predictive value (AUC 0.86, p<0.01).

CONCLUSION

The main pattern of no-reflow phenomenon in STEMI patients undergoing PCI is a combination of distal embolism with severity of inflammatory process. This corresponds to pathophysiological hypothesis of this complication after myocardial revascularization.

Keywords:

no-reflow phenomenon
ST-segment elevation myocardial infarction
myocardial revascularization
coronary artery stenting

Authors:

Bessonov E.Yu.

Alexandrovskaya Hospital

Shishkevich A.N.

Kirov Military Medical Academy;
Mechnikov Northwestern State Medical University

Mikhailov S.S.

Kirov Military Medical Academy;
Mechnikov Northwestern State Medical University

Kravchuk V.N.

Kirov Military Medical Academy;
Mechnikov Northwestern State Medical University

Received:

20.02.2024

Accepted:

17.06.2024

List of references:

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