| Influence of modified shock index and stent coverage surface area on no-reflow phenomenon in patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| Received:December 31, 2020 Revised:February 02, 2021 Click here to download the full text |
| Citation of this paper:XIA Yan,LU Dan-bo,CHEN Zhang-wei,CHEN Ao,WANG Yin-man,QIAN Ju-ying,GE Jun-bo.Influence of modified shock index and stent coverage surface area on no-reflow phenomenon in patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention[J].Chinese Journal of Clinical Medicine,2021,28(2):185-191 |
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| Author Name | Affiliation | E-mail | | XIA Yan | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | | | LU Dan-bo | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | | | CHEN Zhang-wei | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | | | CHEN Ao | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | | | WANG Yin-man | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | | | QIAN Ju-ying | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | qian.juying@zs-hospital.sh.cn | | GE Jun-bo | Department of Cardiology, Zhongshan Hospital, Fudan University
Shanghai Institute of Cardiovascular Diseases
National Clinical Research Center for Interventional Medicinec, Shanghai 200032, China | |
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| Abstract:Objective: To explore the influence of the modified shock index (MSI) and stent coverage surface area (SCSA) on the no-reflow phenomenon (NRP) in acute ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).Methods: A total of 231 STEMI patients who underwent emergency PCI were enrolled in Zhongshan Hospital, Fudan University from June 2018 to June 2019. According to thrombolysis in myocardial infarction (TIMI) blood flow grading of infarct-associated artery during PCI, the patients were divided into NRP group (TIMI grade 0-2, n=48) and normal flow group (TIMI grade 3, n=183). The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) at the beginning of PCI were recorded, and shock index (SI) or modified SI (MSI) was calculated by the ratio of HR and SBP or MAP. The mean diameter (D) and total length (L) of all implanted stents were recorded, and SCSA was calculated as formula π×D×L. The related factors of NRP were analyzed by multivariate logistic regression.Results: Compared with the normal blood flow group, age, history of diabetes ratio, and Killip grade Ⅲ/Ⅳ ratio in the NRP group increased significantly, the SBP, DBP, and MAP were significantly decreased, and the SI, MSI, D, and SCSA were significantly increased (all P<0.05). Patients with NRP were associated with poor prognosis, and in-hospital mortality was significantly higher in the NRP group than that in the normal blood flow group (6.3% vs 0.5%, P=0.030). When MSI≥1.2, SI≥0.7, and SBP<100 mmHg, the odds ratio to predicate NRP risk were 3.365, 3.025, and 2.957, respectively(P<0..05). Similarly, when SCSA≥350 mm2 and D>3.0 mm, the odds ratio to predicate NRP risk were 2.836 and 2.138(P<0.05). Conclusions: MSI≥1.2 and SCSA≥350 mm2 maybe independent risk factors for NRP in patients with primary STEMI undergoing PCI, and the patients with NRP have high in-hospital mortality. |
| keywords:acute myocardial infarction percutaneous coronary intervention no-reflow phenomenon modified shock index stent coverage surface area |
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