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- Title
Development and Validation of a Clinical Risk Score Predicting the No-Reflow Phenomenon in Patients Treated with Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction.
- Authors
Wang, Jin-Wen; Chen, Yun-Dai; Wang, Chang-Hua; Yang, Xin-Chun; Zhu, Xiao-Ling; Zhou, Zi-Qiang
- Abstract
Objective: The 'no-reflow' phenomenon after a primary percutaneous coronary intervention (pPCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) is a strong predictor of both short- and long-term mortality. We therefore developed and prospectively validated a risk score system in order to identify STEMI patients at high risk in terms of no-reflow after primary PCI. Methods: The first part of our study used data from 1,615 STEMI patients who underwent primary PCI within 12 h from symptom onset. Using logistic regression, we derived a risk score to predict angiographic no-reflow using baseline clinical variables. From this score, we developed a simplified fast-track screen that can be used before reperfusion. In the second part of our study, we prospectively validated the score system using receiver-operating characteristic (ROC) curves with data from 692 STEMI patients. Results: The model included six clinical items: age, neutrophil count, admission plasma glucose, β-blocker treatment, time-to-hospital admission and Killip classes. The risk score system demonstrated a good risk prediction with a c-statistic of 0.757 (95% CI 0.732-0.781) based on ROC analysis. Conclusion: A simple risk score system based on clinical variables is useful to predict the risk of developing no-reflow after pPCI in patients with STEMI. Copyright © 2013 S. Karger AG, Basel
- Subjects
MYOCARDIAL infarction; CORONARY disease; CORONARY artery bypass; NEUTROPHILS; BLOOD plasma; REPERFUSION
- Publication
Cardiology, 2013, Vol 124, Issue 3, p153
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000346386