Prediction value and short-term prognosis of slow blood flow/no-reflow during emergency PCI in pa-tients with acute ST-segment elevation myocardial infarction based on a novel immediate scoring system during coronary angiography
Prediction value and short-term prognosis of slow blood flow/no-reflow during emergency PCI in pa-tients with acute ST-segment elevation myocardial infarction based on a novel immediate scoring system during coronary angiography
Objective To establish a new scoring system based on clinical and intraoperative imaging indicators to evaluate the risk of slow blood flow/no-reflow during primary PCI(PPCI)treatment for acute ST-segment elevation myocardial infarction(STEMI).Method 325 STEMI patients who underwent PPCI were selected as the derivation group in this study.In addition,412 consecutive patients were selected as the validation group to verify the predictive value of the scoring system for slow flow/no-reflow(SF/NRF).Furthermore,evaluate the correlation between major adverse cardiovascular events(MACE)in the high-risk and low-risk groups of the scoring system during hospitalization.Results This study used five variables to establish an SF/NRF prediction model.The independent predictive factors for SF/NRF were Killip≥2,time from symptom onset to balloon dilation ≥ 4 hours,initial TIMI blood flow level 0,contrast thrombus burden grade ≥ 4,and IRA diameter≥3.5 mm.Based on the OR value,the independent predictive factors of SF/NRF were scored,and an independent predictive factor prediction model for SF/NRF was established.Analysis using the receiver operating characteristic curve(ROC)showed that the sensitivity and specificity of the model for predicting SF/NRF were 81.2％and 72.3％,with a score of ≥7(AUC=0.845,95％CI:0.788～0.902,P=0.012).The sensitivity and specificity of using this model to predict SF/NRF were 78.2％and 69.5％(AUC=0.752,95％CI:0.687～0.827,P=0.021)when scoring ≥7 points in the validation team.The major adverse cardiovascular events(MACE)during hospitalization in the high-risk group(≥7 points)were significantly higher in the modeling group,validation group,and overall population than in the control group.Conclusion The novel scoring system based on immediate coronary angiography has good predictive value for SF/NRF during PPCI in STEMI patients,and the MACE during hospitalization in high-risk groups is significantly higher than that in low-risk groups.
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