TY  - JOUR
AU  - Chan, W
AU  - Stub, D
AU  - Clark, DJ
AU  - Ajani, AE
AU  - Andrianopoulos, N
AU  - Brennan, AL
AU  - New, G
AU  - Black, A
AU  - Shaw, JA
AU  - Reid, CM
AU  - Dart, AM
AU  - Duffy, SJ
Y2  - 2014/05/22
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y2  - 2011/09/30
Y1  - 2012/02/15
SN  - 0002-9149
UR  - http://hdl.handle.net/11343/33072
AB  - The no reflow phenomenon is reported to occur in >2% of all percutaneous coronary interventions (PCIs) and portends a poor prognosis. We analyzed data from 5,286 consecutive patients who underwent PCI from the Melbourne Interventional Group (MIG) registry from April 2004 through January 2008 who had 30-day follow-up completed. Patients without no reflow (normal reflow, n = 5,031) were compared to 255 (4.8%) with no reflow (n = 217 for transient no reflow, n = 38 for persistent no reflow). Patients with transient or persistent no reflow were more likely to present with ST-elevation myocardial infarction (MI) or cardiogenic shock (p <0.0001 for the 2 comparisons). They were also more likely to have complex lesions (American College of Cardiology/American Heart Association type B2/C), have lesions within a bypass graft, require an intra-aortic balloon pump, receive glycoprotein IIb/IIIa inhibition, and have a longer mean stent length (p <0.0001 for all comparisons). In-hospital outcomes were significantly worse in those patients with transient or persistent no reflow, with increased death, periprocedural MI, renal impairment, and major adverse cardiac events (p <0.0001 for all comparisons). Similarly, transient and persistent no reflow portended worse 30-day clinical outcomes, with a progressive increase in mortality (normal reflow 1.7% vs transient no reflow 5.5% vs persistent no reflow 13.2%, p <0.0001), MI, target vessel revascularization, and major adverse cardiac events (p <0.0001 for all comparisons) compared to patients with normal flow. In conclusion, transient or persistent no reflow complicates approximately 1 in 20 PCIs and results in stepwise increases in in-hospital and 30-day adverse outcomes.
N1  - application/pdf
LA  - English
PB  - EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
KW  - Cardiology (incl. Cardiovascular Diseases); Cardiovascular System and Diseases
T1  - Usefulness of Transient and Persistent No Reflow to Predict Adverse Clinical Outcomes Following Percutaneous Coronary Intervention
DO  - 10.1016/j.amjcard.2011.09.037
IS  - AMERICAN JOURNAL OF CARDIOLOGY
VL  - 109
IS  - 4
SP  - 478-485
L1  - /bitstream/handle/11343/33072/297737_17117.pdf?sequence=1&isAllowed=n
ER  -