Usefulness of transient and persistent no reflow to predict adverse clinical outcomes following percutaneous coronary intervention
MetadataShow full item record
The no reflow phenomenon is reported to occur in >2% of all percutaneous coronary interventions (PCIs) and portends a poor prognosis. We analyzed data from 5,286 consecutive patients who underwent PCI from the Melbourne Interventional Group (MIG) registry from April 2004 through January 2008 who had 30-day follow-up completed. Patients without no reflow (normal reflow, n = 5,031) were compared to 255 (4.8%) with no reflow (n = 217 for transient no reflow, n = 38 for persistent no reflow). Patients with transient or persistent no reflow were more likely to present with ST-elevation myocardial infarction (MI) or cardiogenic shock (p <0.0001 for the 2 comparisons). They were also more likely to have complex lesions (American College of Cardiology/American Heart Association type B2/C), have lesions within a bypass graft, require an intra-aortic balloon pump, receive glycoprotein IIb/IIIa inhibition, and have a longer mean stent length (p <0.0001 for all comparisons). In-hospital outcomes were significantly worse in those patients with transient or persistent no reflow, with increased death, periprocedural MI, renal impairment, and major adverse cardiac events (p <0.0001 for all comparisons). Similarly, transient and persistent no reflow portended worse 30-day clinical outcomes, with a progressive increase in mortality (normal reflow 1.7% vs transient no reflow 5.5% vs persistent no reflow 13.2%, p <0.0001), MI, target vessel revascularization, and major adverse cardiac events (p <0.0001 for all comparisons) compared to patients with normal flow. In conclusion, transient or persistent no reflow complicates approximately 1 in 20 PCIs and results in stepwise increases in in-hospital and 30-day adverse outcomes. © 2012 Elsevier Inc. All rights reserved.
Showing items related by title, author, creator and subject.
Clifford, Rhonda (2004)People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention ...
The impact of lifestyle factors on the clinical outcomes of in vitro fertilisation-embryo transfer (IVF) treatmentJoesbury, Karen Ann (2003)Objectives: To determine the effect of female and male cigarette smoking, caffeine and alcohol consumption, stress and indicators of dietary status on the clinical outcomes of NF treatment. Design: Prospective cohort ...
Elhebir, Elsamaul Suliman A. (2011)Lower urinary tract symptoms (LUTS) are a group of obstructive and irritative urinary symptoms. These include storage, voiding, and post-micturition symptoms. LUTS are prevalent and bothersome in the rapidly growing ageing ...