Vol. 24 No. 3S (2020): Frontiers of endovascular surgery
ORIGINAL ARTICLES

Development of a risk score for no-reflow phenomenon after percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction

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  • I. Bessonov,
  • V. Kuznetsov,
  • E. Gorbatenko,
  • S. Sapozhnikov,
  • A. Dyakova,
  • I. Zyrianov,
  • T. Petelina
I. Bessonov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
Bio
V. Kuznetsov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
E. Gorbatenko
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
S. Sapozhnikov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
A. Dyakova
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
I. Zyrianov
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
T. Petelina
Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Sciences, Tyumen
DOI: https://doi.org/10.21688/1681-3472-2020-3S-68-76

Published 2020-11-06

Keywords

  • no-reflow,
  • risk score,
  • ST-elevation myocardial infarction

How to Cite

Bessonov, I., Kuznetsov, V., Gorbatenko, E., Sapozhnikov, S., Dyakova, A., Zyrianov, I., & Petelina, T. (2020). Development of a risk score for no-reflow phenomenon after percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 24(3S), 68–76. https://doi.org/10.21688/1681-3472-2020-3S-68-76

Copyright (c) 2020 Bessonov I.S., Kuznetsov V.A., Gorbatenko E.A., Sapozhnikov S.S., Dyakova A.O., Zyrianov I.P., Petelina T.A.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background. No-reflow phenomenon during primary percutaneous coronary intervention (PCI) is a significant clinical problem in patients with ST-elevation myocardial infarction (STEMI), and its predictors remain unclear.
Aim. To develop a scoring system to predict the risk of no-reflow in patients undergoing PCI for STEMI.
Methods. Data were collected from 1280 consecutive patients with STEMI (59.2±11.4 years, 74.2% men, 5.2% no-reflow) who were admitted to the coronary care unit and underwent PCI. Baseline clinical, angiographic and procedural variables were used to develop the risk score in a training dataset (n=888, 70%) which was then validated in a test dataset (n=392, 30%). A credit risk assessment tool was used to construct a precise screening tool for no-reflow.
Results. The model comprised age, pain to revascularisation time, neutrophil count, admission plasma glucose level, initial TIMI flow and direct stenting as the only independent predictors of no-reflow. These factors were weighted and used to develop a risk score ranging from 0 to 7. In the training dataset, the optimal threshold score for predicting no-reflow was ≥35, with 69% sensitivity and 81% specificity (area under the curve (AUC) = 0.84, p < 0.001). When these findings were applied to the test dataset, the AUC was 0.75 (p < 0.001), with 70% sensitivity and 80% specificity.
Conclusion. The score developed in this study, based on clinical, angiographic and procedural features, can be used with acceptable accuracy to predict no-reflow in STEMI patients treated by PCI.

Received 29 August 2019. Revised 25 March 2020. Accepted 16 April 2020.

Funding: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

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