ISMJ

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Background: Primary percutaneous angioplasty is a modality of choice to restore reperfusion in infarct related artery now. No-reflow phenomenon is a complication of this modality that increase mortality and morbidity of patients. Assessment of its associated and predictor factors may be useful to its prevention. Methods: All patients with ST elevation myocardial infarction (STEMI) who treated with primary percutaneous angioplasty during 30 months were enrolled to the study.Then patients with and without no-reflow phenomenon assigned to two groups and statistical analysis was performed. Results: Twenty one cases of no-reflow were found in total 263 cases of primary PCI (7.9%). Mean age and prevalence of risk factors such as diabetes mellitus, smoking, hypertension and hyperlipidemia wasn't different in two groups. No- reflow was observed more frequently in females (P<0.01). Mean symptom to balloon time was longer in No-reflow group (P <0.01). Patients with no- reflow phenomenon have more cardiogenic shock, less predischarge ejection fraction, more inhaspital mortality, longer stent length, more LAD as infarct related artery and more use of thrombectomy( p value <0.05). There wasn't statistical significant in presence of collateral vessels, visible calcification, GP IIb/IIIa inhibitors usage, predilation, post dilation, and stent diameter (p value >0.05). Conclusion: The study demonstrated that female gender, LAD as infarct related artery, use of long stents and primary PCI in prolonged symptom to balloon time could be predictors of no- reflow phenomenon.

Keywords: myocardial infarction, stent, complications, primary angioplasty, No-reflow phenomenon

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