Original Article PREDICTORS AND IN-HOSPITAL MORTALITY OF SLOW FLOWNO-REFLOW AFTER PERCUTANEOUS CORONARY INTERVENTION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

Abstract

Objectives: To detect the frequency of slow flow/no-reflow in patients with ST-elevation myocardial infarction (STEMI) after the primary percutaneous coronary intervention (P-PCI), determine its association with various clinical, echocardiographic & angiographic factors and detect in-hospital mortality in these patients.

Methodology: It was a descriptive, cross-sectional study in which 153 STEMI patients were included by convenient sampling at the Rawalpindi Institute of Cardiology. After taking approval from the Hospital’s ethics committee, the study was conducted from March 2022 to August 2022. After obtaining informed written consent, all the patients underwent P-PCI. The statistical analysis was done with the Statistical Package for the Social Sciences version 25.

Results: Slow flow/no-reflow occurred in 19(12.4%) patients. It had a significant association with age groups (p-value = 0.03), prior myocardial infarction (MI) (p-value = 0.000), time to treatment initiation (p-value = 0.000), Killip class (p-value = 0.000), MI type (p-value = 0.036), target lesion length (p-value = 0.000), occlusion site (p-value = 0.004), and thrombus grade (p-value = 0.031). Out of 153 patients, 13(8.5%) patients died with 8(61.5%) of them with slow/no-reflow.

Conclusion: Slow flow/no-reflow is a frequent complication (12.4%) in patients who underwent P-PCI for STEMI. Its significant predictors are advanced age, prior MI, longer time to treatment initiation, higher Killip class, anterior wall MI, longer target lesions, proximal occlusion site, and high thrombus burden. The in-hospital mortality is much higher in these patients.