Incidence and outcome of no flow after primary percutaneous coronary intervention in acute myocardial infarction
Background: Mechanical revascularization of the infarct-related artery (IRA) is the most effective treatment modality in ST-segment elevation myocardial infarction (STEMI).No flow occurs in ∼8.8-10% of cases of primary percutaneous coronary intervention(PCI) in STEMI patients. Our aim was t...
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| Format: | Article |
| Language: | English |
| Published: |
Indonesian Heart Association
2021-03-01
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| Series: | Majalah Kardiologi Indonesia |
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| Online Access: | http://ijconline.id/index.php/ijc/article/view/987 |
| Summary: | Background: Mechanical revascularization of the infarct-related artery (IRA)
is the most effective treatment modality in ST-segment elevation myocardial
infarction (STEMI).No flow occurs in ∼8.8-10% of cases of primary
percutaneous coronary intervention(PCI) in STEMI patients. Our aim was to study
actual incidence and outcome of no flow patients.
Methods: Five hundred and eighty primary PCI patients
were studied over a period of two years i.e. January 2016 to December 2017.
Drug eluting stents were used in all cases. Majority of our patients(>90%) came 6
hours after onset of chest pain. There were many patients where there was
no flow even after mechanical thrombus aspiration and pharmacological
vasodilator therapy. We have studied primary outcome(mortality) of no flow in
those patients.
Results: There were 44 cases of no flow in our
series(7.75%). Left anterior descending artery(LAD )was involved in eighteen
patients. Right coronary artery(RCA) was culprit in twenty four cases. Only
two cases were seen in LCX territory. One month mortality rate in no flow group
was 50% and 6.25% in successful recanalization group. One year mortality was
12.5% in successful recanalization group and 66% in no flow group.
Conclusion: Refractory no flow during primary PCI in STEMI is associated
with high mortality and morbidity. There is no established strategy to solve
this phenomenon. |
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| ISSN: | 0126-3773 2620-4762 |