Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis
BackgroundThe no-reflow phenomenon affects about one out of five patients undergoing Primary Percutaneous Coronary Intervention (PPCI). As the prolonged no-reflow phenomenon is linked with unfavorable outcomes, making early recognition is crucial for effective management and improved clinical outcom...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1295964/full |
| _version_ | 1797356518318800896 |
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| author | Elmira Jafari Afshar Niloofar Gholami Parham Samimisedeh MohammadHossein MozafaryBazargany Amirhossein Tayebi Amirhossein Memari Shahrooz Yazdani Hadith Rastad |
| author_facet | Elmira Jafari Afshar Niloofar Gholami Parham Samimisedeh MohammadHossein MozafaryBazargany Amirhossein Tayebi Amirhossein Memari Shahrooz Yazdani Hadith Rastad |
| author_sort | Elmira Jafari Afshar |
| collection | DOAJ |
| description | BackgroundThe no-reflow phenomenon affects about one out of five patients undergoing Primary Percutaneous Coronary Intervention (PPCI). As the prolonged no-reflow phenomenon is linked with unfavorable outcomes, making early recognition is crucial for effective management and improved clinical outcomes in these patients. Our review study aimed to determine whether electrocardiogram (ECG) findings before PCI could serve as predictors for the occurrence of the no-reflow phenomenon.Methods and materialsWe systematically searched MEDLINE, Scopus, and Embase to identify relevant studies. The random-effect model using inverse variance and Mantel-Haenszel methods were used to pool the standardized mean differences (SMD) and odds ratios (OR), respectively.ResultSixteen eligible articles (1,473 cases and 4,264 controls) were included in this study. Based on our meta-analysis of baseline ECG findings, the no-reflow group compared to the control group significantly had a higher frequency of fragmented QRS complexes (fQRS) (OR (95% CI): 1.35 (0.32–2.38), P-value = 0.01), and Q-waves (OR (95% CI): 1.97 (1.01–2.94), P-value <0.001). Also, a longer QRS duration (QRSD) (SMD (95% CI): 0.72 (0.21, 1.23), p-value <0.001) and R wave peak time (RWPT) (SMD (95% CI): 1.36 (0.8, 1.93), P < 0.001) were seen in the no-reflow group. The two groups had no significant difference regarding P wave peak time (PWPT), and P wave maximum duration (Pmax) on baseline ECG.ConclusionOur findings suggest that prolonged QRSD, delayed RWPT, higher fQRS prevalence, and the presence of a Q wave on baseline ECG may predict the occurrence of the no-reflow phenomenon in patients undergoing PPCI. |
| first_indexed | 2024-03-08T14:28:48Z |
| format | Article |
| id | doaj.art-26f2ac9be4804f93a1b0385eb6e1d17f |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-08T14:28:48Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-26f2ac9be4804f93a1b0385eb6e1d17f2024-01-12T15:51:33ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-01-011010.3389/fcvm.2023.12959641295964Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysisElmira Jafari Afshar0Niloofar Gholami1Parham Samimisedeh2MohammadHossein MozafaryBazargany3Amirhossein Tayebi4Amirhossein Memari5Shahrooz Yazdani6Hadith Rastad7Cardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranRajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IranCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranCardiovascular Research Center, Alborz University of Medical Sciences, Alborz, IranBackgroundThe no-reflow phenomenon affects about one out of five patients undergoing Primary Percutaneous Coronary Intervention (PPCI). As the prolonged no-reflow phenomenon is linked with unfavorable outcomes, making early recognition is crucial for effective management and improved clinical outcomes in these patients. Our review study aimed to determine whether electrocardiogram (ECG) findings before PCI could serve as predictors for the occurrence of the no-reflow phenomenon.Methods and materialsWe systematically searched MEDLINE, Scopus, and Embase to identify relevant studies. The random-effect model using inverse variance and Mantel-Haenszel methods were used to pool the standardized mean differences (SMD) and odds ratios (OR), respectively.ResultSixteen eligible articles (1,473 cases and 4,264 controls) were included in this study. Based on our meta-analysis of baseline ECG findings, the no-reflow group compared to the control group significantly had a higher frequency of fragmented QRS complexes (fQRS) (OR (95% CI): 1.35 (0.32–2.38), P-value = 0.01), and Q-waves (OR (95% CI): 1.97 (1.01–2.94), P-value <0.001). Also, a longer QRS duration (QRSD) (SMD (95% CI): 0.72 (0.21, 1.23), p-value <0.001) and R wave peak time (RWPT) (SMD (95% CI): 1.36 (0.8, 1.93), P < 0.001) were seen in the no-reflow group. The two groups had no significant difference regarding P wave peak time (PWPT), and P wave maximum duration (Pmax) on baseline ECG.ConclusionOur findings suggest that prolonged QRSD, delayed RWPT, higher fQRS prevalence, and the presence of a Q wave on baseline ECG may predict the occurrence of the no-reflow phenomenon in patients undergoing PPCI.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1295964/fullcoronary no-reflowECGelectrocardiogramno-reflow phenomenonpercutaneous coronary interventionPPCI |
| spellingShingle | Elmira Jafari Afshar Niloofar Gholami Parham Samimisedeh MohammadHossein MozafaryBazargany Amirhossein Tayebi Amirhossein Memari Shahrooz Yazdani Hadith Rastad Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis Frontiers in Cardiovascular Medicine coronary no-reflow ECG electrocardiogram no-reflow phenomenon percutaneous coronary intervention PPCI |
| title | Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis |
| title_full | Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis |
| title_fullStr | Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis |
| title_full_unstemmed | Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis |
| title_short | Utility of electrocardiogram to predict the occurrence of the no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention (PPCI): a systematic review and meta-analysis |
| title_sort | utility of electrocardiogram to predict the occurrence of the no reflow phenomenon in patients undergoing primary percutaneous coronary intervention ppci a systematic review and meta analysis |
| topic | coronary no-reflow ECG electrocardiogram no-reflow phenomenon percutaneous coronary intervention PPCI |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1295964/full |
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