Mortality predictors in patients with ST-segment elevation myocardial infarction presenting no-reflow phenomenon after primary PCI: experience of a tertiary center.

Abstract

The mortality rate in subjects with ST-segment elevation acute myocardial infarction (STEMI) is increased because of short- and long-term complications.

Purpose: Our study aims to reveal the death risk and in-hospital mortality predictors in STEMI patients who develop no-reflow phenomenon after primary percutaneous coronary intervention (PCI).

Material and method: Between 01.01.2016 - 31.03.2018, we performed a prospective study including 656 patients with STEMI. We included only patients who underwent myocardial revascularization through the primary PCI method and developed no-reflow phenomenon.

Results: Our study included 96 patients with STEMI and no-reflow phenomenon after PCI, of whom 14 died. Mortality rate was significantly higher in subjects with anterior STEMI compared with inferior STEMI (42.9% vs. 14.3%). The mortality registered after PCI was significantly higher in the coronary no-reflow phenomenon group compared with the myocardial no-reflow group (p = 0.039). Post-PCI mortality was significantly higher in patients with complications than in those without complications (33.33% vs. 1.75%, p <0.001).

Conclusions: The coronary no-reflow phenomenon has the highest risk of mortality, accounting for more than half of the myocardial infarction cases compared with the myocardial no-reflow phenomenon. Most of the deaths were reported in subjects with STEMI and the no-reflow phenomenon, who developed cardiovascular complications.