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Review
. 2018 Dec;70 Suppl 3(Suppl 3):S406-S418.
doi: 10.1016/j.ihj.2018.01.032. Epub 2018 Jan 31.

The predictors of no reflow phenomenon after percutaneous coronary intervention in patients with ST elevation myocardial infarction: A meta-analysis

Jonny Karunia Fajar  1 , Teuku Heriansyah  2 , Mohammad Saifur Rohman  3
Affiliations
Review

The predictors of no reflow phenomenon after percutaneous coronary intervention in patients with ST elevation myocardial infarction: A meta-analysis

Jonny Karunia Fajar et al. Indian Heart J. 2018 Dec.

Abstract

Objective: To investigate the no reflow risk factors after percutaneous coronary intervention in ST elevation myocardial infarction patients.

Method: Sample size, mean±standard deviation (SD) or frequencies (percent) of normal and no reflow groups were extracted from each study.

Results: Of 27 retrospective and prospective studies, we found that increasing risks of no reflow were associated with advanced age, male, family history of coronary artery disease, smoking, diabetes mellitus, hypertension, delayed reperfusion, killip class ≥2, elevated blood glucose, increased creatinine, elevated creatine kinase (CK), higher heart rate, decreased left ventricular ejection fraction (LVEF), collateral flow ≤1, longer lesion length, multivessel disease, reference luminal diameter, initial thrombolysis in myocardial infarction (TIMI) flow, and high thrombus burden. Moreover, initial TIMI flow ≤1 and high thrombus burden had the greater impact on no reflow (OR95%CI=3.83 [2.77-5.29], p<0.0001 and 3.69 [2.39-5.68], p<0.0001, respectively).

Conclusion: Our meta-analysis reveals that initial TIMI flow ≤1 and high thrombus burden are the most impacted no reflow risk factors.

Keywords: Myocardial infarction; No reflow phenomenon; Percutaneous coronary intervention; Risk factors.

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Figures

Fig. 1
Fig. 1
Selection of articles for inclusion in meta-analysis.
Fig. 2
Fig. 2
Forest plot regarding the association between age (A), gender (B), and smoking (C) with the risk of no reflow.
Fig. 3
Fig. 3
Forest plot regarding the association between diabetes mellitus (A), hypentension (B), and symptom to reflow time (C) with the risk of no reflow.
Fig. 4
Fig. 4
Forest plot regarding the association between killip class (A), heart rate (B), and LVEF (C) with the risk of no reflow.
Fig. 5
Fig. 5
Forest plot regarding the association between blood glucose (A), creatinine (B), and peak CK (C) with the risk of no reflow.
Fig. 6
Fig. 6
Forest plot regarding the association between collateral flow (A), lesion length (B), multivessel disease (C), and reference luminal diameter (D) with the risk of no reflow.
Fig. 7
Fig. 7
Forest plot regarding the association between initial TIMI flow (A) and thrombus score (B) with the risk of no reflow.
See this image and copyright information in PMC

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