RESUMO
OBJECTIVES: In the present study, we analysed the incidence of no-reflow phenomenon, its clinical and procedural predictors, and associated in-hospital outcomes for the patients undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: No-reflow phenomenon after primary PCI is a procedural complication associated with adverse post-procedure outcomes. METHODS: Data for this study were extracted from global registry, NCDR®, the site of National Institute of Cardiovascular Disease (NICVD), Karachi from July 2017 to March 2018. The demographic, clinical, and procedural characteristics, and in-hospital outcomes were analysed for the patients with and without no-reflow after primary PCI. RESULTS: Of total of 3255 patients, no-reflow phenomenon was found in 132 (4.1%) patients and it was associated with significantly higher in-hospitality mortality (6.8% vs. 2.9%; pâ¯=â¯0.01), cerebrovascular accident (1.5% vs. 0%; pâ¯<â¯0.001), post procedure bleeding (2.3% vs. 0.5%; pâ¯=â¯0.009), and cardiogenic shock (3.8% vs. 1.2%; pâ¯=â¯0.011). The multivariate analysis showed advanced age [odds ratioâ¯=â¯1.63, 95% confidence interval 1.09-2.44, pâ¯=â¯0.018], diabetes [1.66, 1.14-2.42, pâ¯=â¯0.009], prior history of CABG [8.70, 1.45-52.04, pâ¯=â¯0.018], low pre-procedure TIMI flow grade [2.04, 1.3-3.21, pâ¯=â¯0.002], longer length of target lesion [1.51, 1.06-2.16, pâ¯=â¯0.023], and 10 fold raised troponin I [1.55, 1.08-2.23, pâ¯=â¯0.018] were the independent predictors of no-reflow. CONCLUSIONS: In this selected group of patients, the no-reflow phenomenon after primary percutaneous coronary intervention is not that uncommon. It is associated with an increased risk of adverse post-procedure hospital course including mortality. Pathophysiology of the no-reflow phenomenon is complex and opaque, however, it can be predicted based on certain clinical and procedural characteristics.