Predictors of Suboptimal Reperfusion and Short Term Mortality in Patients Presented With Acute ST-Segment Elevation Myocardial Infarction and Treated With Primary Percutaneous Coronary Intervention

Author:

Abdelmoneum M.S.,Arafa O.S.,Mohamed O.A.El.M.,Mohamed E.A.El.M.,Allam H.I.

Abstract

Background: Predictors of Suboptimal reperfusion are still unclear. Aim: This study aimed to determine the factors that may indicate suboptimal reperfusion and short-term mortality in patients who were diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention (pPCI). Patients and methods: This multicenter prospective comparative study, conducted at Benha University hospitals and National Heart Institute, included 400 patients (age<18 years and both sex) with acute STEMI, who were treated with PPCI. They were divided equally into 2 groups; suboptimal and optimal reperfusion groups (TIMI < III Vs.TIMI III respectively). Clinical data was collected. ECG, laboratory investigations, echocardiographic study, PPCI and 6 months follow up were done to all patients included. Results: This study showed that advanced age (60.4±8.2), family history of CAD, dyslipidemia, being diabetic, prolonged Pain to PCI time, higher random blood sugar (RBG) at the time of presentation, Killip class >1, heavy thrombus burden, prediltation, multiple stents insertion and longer stent length are predictors of the SOR after PPCI. While, Patients on long term beta blockers (BB) and angiotensin-converting enzyme inhibitor (ACEI) are less likely to develop SOR. Furthermore, patients with SOR are more likely to develop in-hospital arrhythmias, heart failure, acute mitral regurge and inhospital mortality. Additionally, it increases 6-months risk of reischemia and mortality. Conclusions: Predicting the occurrence of no-reflow following pPCI can be achieved by considering various factors, such as clinical data, laboratory results, angiographic features, and procedural characteristics. Heavy thrombus burden, prediltation, dyslipidemia, longer stent length, pain to PCI time and RBG >300 (mg/dL) at the time of presentation were found to be the most predictable variables to SOR. Long term use of BB and ACEI were found to be significant independent factors that decreased the likelihood of TIMI9h were considered the most predictable variables to mortality in no reflow.

Publisher

RosNOU

Subject

General Engineering,Literature and Literary Theory,History,General Medicine,History,Economics, Econometrics and Finance (miscellaneous),Social Sciences (miscellaneous),Sociology and Political Science,Geography, Planning and Development,Linguistics and Language,Education,Cultural Studies,General Medicine,Sociology and Political Science,Anthropology,History,Geography, Planning and Development,Cultural Studies,Transplantation,Cell Biology,Hematology,Molecular Medicine,Immunology and Allergy,General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3