Incidenza del no-reflow calcolata su oltre 19 000 angioplastiche primarie ed elettive in un singolo centro ad alto volume

Translated title of the contribution: No-reflow phenomenon calculated in over 19,000 primary and elective angioplasty in a high-volume single center

Alessandro Durante, Azeem Latib, Giuseppe Pizzetti, Antonio Colombo, Paolo G. Camici

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background. The no-reflow (NR) phenomenon is frequent in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). However, its real incidence and prognostic significance, so far derived from relatively small patient cohorts, remain poorly defined. Methods. We have retrospectively analyzed 19 290 consecutive PCI performed at our hospital between January 1998 and November 2010. NR was defined as a TIMI flow .2 at the end of the PCI. Results. In the 1257 patients with STEMI, NR occurred in 9.4% of cases and was more common when the left anterior descending coronary artery was the culprit vessel. STEMI-NR patients had longer ischemic times and more frequently multivessel disease. In the STEMI-NR group, glycoprotein IIb/IIIa inhibitors were used in 60.2%, nitroprusside in 39.6%, thrombus aspiration in 10.7% and adenosine in 8.7%. In the remaining 18 033 patients without STEMI undergoing PCI, the NR phenomenon occurred only in 0.2% of cases. STEMI- NR patients had lower left ventricular ejection fraction at discharge (50.3 ± 7.2 vs 44.9 ± 8.4%; p<0.01) and showed higher rates of adverse events (death, non-fatal myocardial infarction, coronary revascularization, new hospital admission for heart failure: 67.8 vs 36.9%, p=0.001), death (25.4 vs 13.2%, p<0.01), myocardial infarction (13.6 vs 4.8%, p<0.01) and hospitalizations for heart failure (13.6 vs 4.8%, p<0.001). Conclusions. Our data, derived from a large cohort of patients from a single center, allow a more correct estimate of the occurrence and prognostic significance of NR. The NR phenomenon is more common in STEMI patients undergoing primary PCI and has an important negative prognostic value.

Translated title of the contributionNo-reflow phenomenon calculated in over 19,000 primary and elective angioplasty in a high-volume single center
Original languageItalian
Pages (from-to)110-115
Number of pages6
JournalGiornale Italiano di Cardiologia
Volume15
Issue number2
StatePublished - Feb 2014
Externally publishedYes

Keywords

  • Ischemic heart disease
  • Myocardial infarction
  • No-reflow phenomenon
  • Reperfusion injury

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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