Meta-analysis of the correlation between inflammatory response indices and no-reflow after PCI in patients with acute STEMI.

Background: After percutaneous coronary intervention (PCI), patients with acute ST-segment elevation myocardial infarction (STEMI) could have an inflammatory response, which may lead to the risk of no-reflow due to microvascular obstruction. However, the association between changes in the levels of inflammatory response-related factors and no-reflow after PCI in patients with acute STEMI is still controversial.

Methods: In this study, a meta-analysis was conducted. Studies from the database established before April 2024 were retrieved in PubMed, Web of Science, and EMBASE. Case-control or cohort studies were included. Repetitive publications, studies without full access and successful data extraction, fragmentary information, animal experiments, summary, and systematic reviews were excluded, and Review Manager 5.3 software was used to process the data.

Results: The meta-analysis showed that elevated levels of high-sensitivity C-reactive protein (Hs-CRP) (Z = 22.87, P < 0.001), platelet/lymphocyte ratio (PLR) (Z = 19.17, P < 0.001), leukocyte (Z = 9.98, P < 0.001), and neutrophil count (Z = 5.75, P < 0.001) were significantly related with the risk of no-reflow. In addition, the increase of red blood cell volume width (RDW) was also a risk factor for no-reflow.

Conclusion: Refined results of Hs-CRP, PLR, RDW, leukocytes, and neutrophil can provide clinicians with effective tools to reduce the risk of no-reflow in patients with acute STEMI after PCI.