MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Abstract Introduction No-reflow phenomenon (NRP) is one of the complications that mostly occur during percutaneous coronary intervention (PCI). In this study, we comprehensively examined the relationship between the model for end-stage liver disease-XI (MELD-XI) score and NRP. Moreover, we discussed...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02556-2 |
| _version_ | 1829136705570996224 |
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| author | Xin-Tao Zhang Zhao-Rong Lin Lin Zhang Zi-Wen Zhao Liang-Long Chen |
| author_facet | Xin-Tao Zhang Zhao-Rong Lin Lin Zhang Zi-Wen Zhao Liang-Long Chen |
| author_sort | Xin-Tao Zhang |
| collection | DOAJ |
| description | Abstract Introduction No-reflow phenomenon (NRP) is one of the complications that mostly occur during percutaneous coronary intervention (PCI). In this study, we comprehensively examined the relationship between the model for end-stage liver disease-XI (MELD-XI) score and NRP. Moreover, we discussed whether the MELD-XI score could be considered as an accurate risk assessment score of patients with ST-segment elevation myocardial infarction (STEMI) who are candidates for PCI. Methods This retrospective study involved 693 patients with acute STEMI and who underwent an emergency PCI. They were divided into a normal reflow group or a no-reflow group on the basis of the flow rate of post-interventional thrombolysis in myocardial infarction. Univariate, multivariate logistic regression, and Cox regression analyses were performed to identify the independent predictors of NRP in both groups. Receiver operator characteristic (ROC) curves and Kaplan–Meier curves were plotted to estimate the predictive values of the MELD-XI score. Results MELD-XI score was found to be an independent indicator of NRP (odds ratio: 1.247, 95% CI: 1.144–1.360, P < 0.001). Multivariate Cox regression analysis also revealed that the MELD-XI score is an independent prognostic factor for 30-day all-cause mortality (hazard ratio: 1.155, 95% CI: 1.077–1.239, P < 0.001). Moreover, according to the ROC curves, the cutoff value of the MELD-XI score to predict NRP was 9.47 (area under ROC curve: 0.739, P < 0.001). The Kaplan–Meier curves for 30-day all-cause mortality revealed lower survival rate in the group with a MELD-XI score of > 9.78 (P < 0.001). Conclusion The MELD-XI score can be used to predict NRP and the 30-day prognosis in patients with STEMI who are candidates for primary PCI. It could be adopted as an inexpensive and a readily available tool for risk stratification. |
| first_indexed | 2024-12-14T18:47:56Z |
| format | Article |
| id | doaj.art-1f67039cdc554e90b650ad5b300a3021 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-14T18:47:56Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-1f67039cdc554e90b650ad5b300a30212022-12-21T22:51:20ZengBMCBMC Cardiovascular Disorders1471-22612022-03-012211810.1186/s12872-022-02556-2MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary interventionXin-Tao Zhang0Zhao-Rong Lin1Lin Zhang2Zi-Wen Zhao3Liang-Long Chen4Department of Cardiology, Union Hospital, Fujian Medical UniversityDepartment of Cardiology, Union Hospital, Fujian Medical UniversityDepartment of Cardiology, Union Hospital, Fujian Medical UniversityDepartment of Cardiology, Union Hospital, Fujian Medical UniversityDepartment of Cardiology, Union Hospital, Fujian Medical UniversityAbstract Introduction No-reflow phenomenon (NRP) is one of the complications that mostly occur during percutaneous coronary intervention (PCI). In this study, we comprehensively examined the relationship between the model for end-stage liver disease-XI (MELD-XI) score and NRP. Moreover, we discussed whether the MELD-XI score could be considered as an accurate risk assessment score of patients with ST-segment elevation myocardial infarction (STEMI) who are candidates for PCI. Methods This retrospective study involved 693 patients with acute STEMI and who underwent an emergency PCI. They were divided into a normal reflow group or a no-reflow group on the basis of the flow rate of post-interventional thrombolysis in myocardial infarction. Univariate, multivariate logistic regression, and Cox regression analyses were performed to identify the independent predictors of NRP in both groups. Receiver operator characteristic (ROC) curves and Kaplan–Meier curves were plotted to estimate the predictive values of the MELD-XI score. Results MELD-XI score was found to be an independent indicator of NRP (odds ratio: 1.247, 95% CI: 1.144–1.360, P < 0.001). Multivariate Cox regression analysis also revealed that the MELD-XI score is an independent prognostic factor for 30-day all-cause mortality (hazard ratio: 1.155, 95% CI: 1.077–1.239, P < 0.001). Moreover, according to the ROC curves, the cutoff value of the MELD-XI score to predict NRP was 9.47 (area under ROC curve: 0.739, P < 0.001). The Kaplan–Meier curves for 30-day all-cause mortality revealed lower survival rate in the group with a MELD-XI score of > 9.78 (P < 0.001). Conclusion The MELD-XI score can be used to predict NRP and the 30-day prognosis in patients with STEMI who are candidates for primary PCI. It could be adopted as an inexpensive and a readily available tool for risk stratification.https://doi.org/10.1186/s12872-022-02556-2No-reflow phenomenonMELD-XIShort-term outcomeST-segment elevation myocardial infarctionLiver and renal dysfunctionPercutaneous coronary intervention |
| spellingShingle | Xin-Tao Zhang Zhao-Rong Lin Lin Zhang Zi-Wen Zhao Liang-Long Chen MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention BMC Cardiovascular Disorders No-reflow phenomenon MELD-XI Short-term outcome ST-segment elevation myocardial infarction Liver and renal dysfunction Percutaneous coronary intervention |
| title | MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_full | MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_fullStr | MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_full_unstemmed | MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_short | MELD-XI score predict no-reflow phenomenon and short-term mortality in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| title_sort | meld xi score predict no reflow phenomenon and short term mortality in patient with st segment elevation myocardial infarction undergoing primary percutaneous coronary intervention |
| topic | No-reflow phenomenon MELD-XI Short-term outcome ST-segment elevation myocardial infarction Liver and renal dysfunction Percutaneous coronary intervention |
| url | https://doi.org/10.1186/s12872-022-02556-2 |
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