Objective To explore impact of preoperative the high-sensitivity troponin T (cTnT) level on no-reflow phenomenon during the operation in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.
Methods Patients who received primary percutaneous coronary intervention due to acute STEMI in Zhongshan Hospital, Fudan University between January 2013 and February 2015 were retrospectively analyzed. A total of 677 patients were enrolled, who were devided into the preoperative cTnT < 5 times the upper limit of normal reference (URL; 5 URL group, n＝337), 5-20 times URL (5-20 URL) group (n＝141), and cTnT > 20 times URL (20 URL) group (n＝199). The association between different levels of preoperative cTnT and no-reflow was analyzed, and multivariate logistic regression analysis was used to analyzed the independent risk factors for the occurrence of no-reflow at different levels of preoperative cTnT.
Results The proportion of TIMI flow grade 0 or 1 at once after coronary stent implantation was 15.4%, 19.1%, and 18.6% (P＝0.499) in 5 URL group, 5-20 URL group, and 20 URL group, respectively. Multivariate logistic analysis suggested that in the 5 URL group, target vessel of anterior descending branch and age > 65 years were independent risk factors for the occurrence of no-reflow, while proximal vessel occlusion and > 65 years old were independent risk factor for the occurrence of no-reflow in the 5-20 URL and 20 URL groups, respectively.
Conclusions In STEMI patients with different preoperative cTnT levels, the risk of no-reflow is comparable, but the risk factors for predicting the occurrence of no-reflow were different.
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