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- Title
Prediction of no-reflow and major adverse cardiovascular events with a new scoring system in STEMI patients.
- Authors
Bayramoğlu, Adil; Taşolar, Hakan; Kaya, Ahmet; Tanboğa, İbrahim Halil; Yaman, Mehmet; Bektaş, Osman; Günaydın, Zeki Yüksel; Oduncu, Vecih
- Abstract
<bold>Background: </bold>No-reflow is associated with a poor prognosis in STEMI patients. There are many factors and mechanisms that contribute to the development of no-reflow, including age, reperfusion time, a high thrombus burden, Killip class, long stent use, ejection fraction ≤40, and a high Syntax score. In this study, we aimed to evaluate the parameters associated with no-reflow prediction by creating a new scoring system.<bold>Methods: </bold>The study included 515 consecutive STEMI patients who underwent PCI; 632 STEMI patients who had undergone PCI in another center were included in the external validation of the scoring system. The correlations between 1-year major adverse cardiac events and low/high risk score were assessed.<bold>Results: </bold>In this study, seven independent variables were used to build a risk score for predicting no-reflow. The predictors of no-reflow are age, EF ≤40, SS ≥22, stent length ≥20, thrombus grade ≥4, Killip class ≥3, and pain-balloon time ≥4 h. In the derivation group, the optimal threshold score for predicting no-reflow was >10, with a 75% sensitivity and 77.7% specificity (Area under the curve (AUC) = 0.809, 95%CI: 0.772-0.842, P < 0.001). In the validation group, AUC was 0.793 (95%CI: 0.760-0.824, P < 0.001).<bold>Conclusion: </bold>This new score, which can be calculated in STEMI patients before PCI and used to predict no-reflow in STEMI patients, may help physicians to estimate the development of no-reflow in the pre-PCI period.
- Subjects
CARDIOVASCULAR diseases; SURGICAL stents; PROGNOSIS; PUBLIC health; HEART diseases
- Publication
Journal of Interventional Cardiology, 2018, Vol 31, Issue 2, p144
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1111/joic.12463