Background. Coronary no-reflow (NR) is a dreadful complication of primary
percutaneous coronary intervention (pPCI) that is seen in nearly 50%
of cases. A great effort is being done to discover simple tools that could
Predict such a complication. We aimed primarily to study the predictive
power of R-wave peak time (RWPT) on NR.
Methods. From October 2017 to March 2018, we enrolled 123 patients
with STEMI treated with pPCI at Benha University Hospital and National
Heart Institute.We measured RWPT from infarct-related artery (IRA) leads
and assessed the development of NR in all finally included 100 patients
(after exclusions).
Results.Based on occurrence of NR, patients were divided into 2 groups;
Group I (n¼ 39) with NR and group II (n¼61) without NR. Smoking, DM,
HTN, longer reperfusion times and higher thrombus burden were significantly
associated with NR. Both pre- and postprocedural RWPT were
significantly higher in group I than Group II. Preprocedural RWPT > 46
milliseconds predicted NR with a sensitivity and specificity of 79.5% and 86.9% respectively (AUC 0.891, 95% CI 0.82 - 0.962, P < .001). In adjusted multivariate analysis, preprocedural RWPT was found to be among independent predictors for NR (OR: 8.8, 95% CI: 1.8- 43.3, P¼ 0.008). The predictive power of preprocedural RWPT was statistically non-inferior to
STresolution (STR)% (difference between area under curves¼ 0.029, P ¼
0.595).
Conclusion. RWPT is strongly associated with and significantly predicts
the development of NR. This association was statistically non-inferior to the well-known association between STR% and NR. |
