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    Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry

    Access Status
    Fulltext not available
    Authors
    Papapostolou, S.
    Andrianopoulos, N.
    Duffy, S.
    Brennan, Angela
    Ajani, A.
    Clark, D.
    Reid, C.
    Freeman, M.
    Sebastian, M.
    Selkrig, L.
    Yudi, M.
    Noaman, S.
    Chan, W.
    Date
    2018
    Type
    Conference Paper
    
    Metadata
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    Citation
    Papapostolou, S. and Andrianopoulos, N. and Duffy, S. and Brennan, A. and Ajani, A. and Clark, D. and Reid, C. et al. 2018. Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry, 28th Annual Transcatheter Cardiovascular Therapeutics Symposium (TCT), pp. 185-193: ELSEVIER SCIENCE INC.
    Source Title
    EuroIntervention
    Source Conference
    28th Annual Transcatheter Cardiovascular Therapeutics Symposium (TCT)
    DOI
    10.4244/EIJ-D-17-00269
    ISSN
    1774-024X
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/69498
    Collection
    • Curtin Research Publications
    Abstract

    © 2018 Europa Digital & Publishing. All rights reserved. Aims: The aim of the study was to evaluate long-term outcomes of transient versus persistent no-reflow. Methods and results: A total of 17,547 patients with normal flow post percutaneous coronary intervention (PCI) were compared to 590 patients (3.2%) with transient no-reflow and 144 patients (0.8%) with persistent no-reflow. Long-term all-cause mortality was obtained by linkage with the National Death Index (NDI). No-reflow patients were more likely to have presented with ST-elevation myocardial infarction (STEMI), out-of-hospital cardiac arrest (OHCA) or cardiogenic shock (all p<0.01). Long-term NDI-linked all-cause mortality was highest in patients with persistent no-reflow (31%) followed by transient no-reflow (22%) and normal flow (14%) over a median follow-up of 5.2, 5.5 and 4.5 years, respectively (all p<0.0001). Kaplan-Meier survival estimates demonstrated a graded increase in all-cause mortality from normal flow, to transient to persistent no-reflow (p<0.01), with the highest mortality occurring early (<30 days) in the persistent no-reflow group (p<0.0001). Multivariate Cox proportional hazards modelling identified glomerular filtration rate <30 mL/min, ejection fraction <30%, persistent no-reflow and transient no-reflow as independent predictors of increased hazard for all-cause mortality (all p<0.05). Conclusions: Transient and persistent no-reflow were associated with a stepwise reduction in long-term survival. The presence of even transient no-reflow appears to be an important predictor of adverse long-term outcome.

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