급성 심근경색증에서 관상동맥 중재술시 발생하는 reflow disturbance 현상의 위험인자
Risk factors for reflow disturbance phenomenon during percutaneous coronary intervention in patients with acute myocardial infarction
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Background/Aims : The reflow disturbance phenomenon is associated with poor functional and clinical outcomes for patients suffering with acute myocardial infarction (AMI). In the era of primary coronary intervention (PCI), accurately identifying those lesions that are at a high risk of no-reflow is of crucial importance. Therefore, we investigated the risk factors of the reflow disturbance phenomenon in AMI patients who underwent PCI. Methods : From February 2003 to June 2005, the clinical and angiographic characteristics of 475 patients who had undergone PCI were reviewed retrospectively. Results : 65 patients (13.7%) showed the reflow disturbance phenomenon and the reperfusion times of the reflow disturbance group ranged from 1 hour to 142 hours. On univariate analysis, an older age (p<0.001), low systolic blood pressure (p=0.01), no thrombolysis followed by PCI (p<0.001), primary PCI (p<0.001), less time to PCI (p=0.001), a high peak serum CK-MB level (p=0.013), angiographically visible thrombus (p=0.016), a low pre-TIMI grade (p=0.021) and ST segment elevation on the ECG (p=0.002) were the significant risk factors of the reflow disturbance phenomenon. An older age, a low systolic BP and angiographically visible thrombus were significant risk factors on multivariate analysis. Conclusion : An older age, low systolic blood pressure and angiographically visible thrombus were the independent risk factors for the reflow disturbance phenonmenon in AMI patients who undergo PCI. (Korean J Med 74:16-22, 2008)
Abstract
Background/Aims : The reflow disturbance phenomenon is associated with poor functional and clinical outcomes for patients suffering with acute myocardial infarction (AMI). In the era of primary coronary intervention (PCI), accurately identifying those lesions that are at a high risk of no-reflow is of crucial importance. Therefore, we investigated the risk factors of the reflow disturbance phenomenon in AMI patients who underwent PCI. Methods : From February 2003 to June 2005, the clinical and angiographic characteristics of 475 patients who had undergone PCI were reviewed retrospectively. Results : 65 patients (13.7%) showed the reflow disturbance phenomenon and the reperfusion times of the reflow disturbance group ranged from 1 hour to 142 hours. On univariate analysis, an older age (p<0.001), low systolic blood pressure (p=0.01), no thrombolysis followed by PCI (p<0.001), primary PCI (p<0.001), less time to PCI (p=0.001), a high peak serum CK-MB level (p=0.013), angiographically visible thrombus (p=0.016), a low pre-TIMI grade (p=0.021) and ST segment elevation on the ECG (p=0.002) were the significant risk factors of the reflow disturbance phenomenon. An older age, a low systolic BP and angiographically visible thrombus were significant risk factors on multivariate analysis. Conclusion : An older age, low systolic blood pressure and angiographically visible thrombus were the independent risk factors for the reflow disturbance phenonmenon in AMI patients who undergo PCI. (Korean J Med 74:16-22, 2008)
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