Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization
Background. Distal embolization due to microthrombus fragments formed during predilation ballooning is considered one of the possible mechanisms of slow flow/no-reflow (SF/NR). Therefore, this study aimed to compare the incidence of intraprocedure SF/NR during the primary percutaneous coronary inter...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Hindawi-Wiley
2023-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2023/4012361 |
| _version_ | 1797952219319894016 |
|---|---|
| author | Rajesh Kumar Danish Qayyum Ifikhar Ahmed Lajpat Rai Ayaz Mir Romana Awan Ali Bin Naseer Abdul Basit Jawaid Akbar Sial Tahir Saghir Nadeem Qamar Musa Karim |
| author_facet | Rajesh Kumar Danish Qayyum Ifikhar Ahmed Lajpat Rai Ayaz Mir Romana Awan Ali Bin Naseer Abdul Basit Jawaid Akbar Sial Tahir Saghir Nadeem Qamar Musa Karim |
| author_sort | Rajesh Kumar |
| collection | DOAJ |
| description | Background. Distal embolization due to microthrombus fragments formed during predilation ballooning is considered one of the possible mechanisms of slow flow/no-reflow (SF/NR). Therefore, this study aimed to compare the incidence of intraprocedure SF/NR during the primary percutaneous coronary intervention (PCI) in patients with high thrombus burden (≥4 grade) with and without predilation ballooning for culprit lesion preparation. Methodology. This prospective descriptive cross-sectional study included patients with a high thrombus burden (≥4 grades) who underwent primary PCI. Propensity-matched cohorts of patients with and without predilation ballooning in a 1 : 1 ratio were compared for the incidence of intraprocedure SF/NR. Results. A total of 765 patients with high thrombus burden undergoing primary PCI were included in this study. The mean age was 55.75 ± 11.54 years, and 78.6% (601) were males. Predilation ballooning was conducted in 346 (45.2%) patients. The incidence of intraprocedure SF/NR was significantly higher (41.3% vs. 27.4%; p<0.001) in patients with predilation ballooning than in those without preballooning, respectively. The incidence of intraprocedure SF/NR also remained significantly higher for the predilation ballooning cohort with an incidence rate of 41.3% as against 30.1% (p=0.002) for the propensity-matched cohort of patients without predilation ballooning with a relative risk of 1.64 (95% CI: 1.20 to 2.24). Moreover, the in-hospital mortality rate remained higher but insignificant, among patients with and without predilation ballooning (8.1% vs. 4.9%; p=0.090). Conclusion. In conclusion, predilation ballooning can be associated with an increased risk of incidence of intraprocedure SF/NR during primary PCI in patients with high thrombus burden. |
| first_indexed | 2024-04-10T22:43:12Z |
| format | Article |
| id | doaj.art-84e12d8523ea4587b6d6e8f5ae34f556 |
| institution | Directory Open Access Journal |
| issn | 1540-8183 |
| language | English |
| last_indexed | 2024-04-10T22:43:12Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi-Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj.art-84e12d8523ea4587b6d6e8f5ae34f5562023-01-16T01:06:10ZengHindawi-WileyJournal of Interventional Cardiology1540-81832023-01-01202310.1155/2023/4012361Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary RevascularizationRajesh Kumar0Danish Qayyum1Ifikhar Ahmed2Lajpat Rai3Ayaz Mir4Romana Awan5Ali Bin Naseer6Abdul Basit7Jawaid Akbar Sial8Tahir Saghir9Nadeem Qamar10Musa Karim11National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)National Institute of Cardiovascular Diseases (NICVD)Background. Distal embolization due to microthrombus fragments formed during predilation ballooning is considered one of the possible mechanisms of slow flow/no-reflow (SF/NR). Therefore, this study aimed to compare the incidence of intraprocedure SF/NR during the primary percutaneous coronary intervention (PCI) in patients with high thrombus burden (≥4 grade) with and without predilation ballooning for culprit lesion preparation. Methodology. This prospective descriptive cross-sectional study included patients with a high thrombus burden (≥4 grades) who underwent primary PCI. Propensity-matched cohorts of patients with and without predilation ballooning in a 1 : 1 ratio were compared for the incidence of intraprocedure SF/NR. Results. A total of 765 patients with high thrombus burden undergoing primary PCI were included in this study. The mean age was 55.75 ± 11.54 years, and 78.6% (601) were males. Predilation ballooning was conducted in 346 (45.2%) patients. The incidence of intraprocedure SF/NR was significantly higher (41.3% vs. 27.4%; p<0.001) in patients with predilation ballooning than in those without preballooning, respectively. The incidence of intraprocedure SF/NR also remained significantly higher for the predilation ballooning cohort with an incidence rate of 41.3% as against 30.1% (p=0.002) for the propensity-matched cohort of patients without predilation ballooning with a relative risk of 1.64 (95% CI: 1.20 to 2.24). Moreover, the in-hospital mortality rate remained higher but insignificant, among patients with and without predilation ballooning (8.1% vs. 4.9%; p=0.090). Conclusion. In conclusion, predilation ballooning can be associated with an increased risk of incidence of intraprocedure SF/NR during primary PCI in patients with high thrombus burden.http://dx.doi.org/10.1155/2023/4012361 |
| spellingShingle | Rajesh Kumar Danish Qayyum Ifikhar Ahmed Lajpat Rai Ayaz Mir Romana Awan Ali Bin Naseer Abdul Basit Jawaid Akbar Sial Tahir Saghir Nadeem Qamar Musa Karim Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization Journal of Interventional Cardiology |
| title | Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization |
| title_full | Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization |
| title_fullStr | Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization |
| title_full_unstemmed | Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization |
| title_short | Predilation Ballooning in High Thrombus Laden STEMIs: An Independent Predictor of Slow Flow/No-Reflow in Patients Undergoing Emergent Percutaneous Coronary Revascularization |
| title_sort | predilation ballooning in high thrombus laden stemis an independent predictor of slow flow no reflow in patients undergoing emergent percutaneous coronary revascularization |
| url | http://dx.doi.org/10.1155/2023/4012361 |
| work_keys_str_mv | AT rajeshkumar predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT danishqayyum predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT ifikharahmed predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT lajpatrai predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT ayazmir predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT romanaawan predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT alibinnaseer predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT abdulbasit predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT jawaidakbarsial predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT tahirsaghir predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT nadeemqamar predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization AT musakarim predilationballooninginhighthrombusladenstemisanindependentpredictorofslowflownoreflowinpatientsundergoingemergentpercutaneouscoronaryrevascularization |