Development of a risk score for no-reflow phenomenon after percutaneous coronary interventions in patients with ST-segment elevation myocardial infarction

Background. No-reflow phenomenon during primary percutaneous coronary intervention (PCI) is a significant clinical problem in patients with ST-elevation myocardial infarction (STEMI), and its predictors remain unclear. Aim. To develop a scoring system to predict the risk of no-reflow in patients undergoing PCI for STEMI. Methods. Data were collected from 1280 consecutive patients with STEMI (59.2±11.4 years, 74.2% men, 5.2% no-reflow) who were admitted to the coronary care unit and underwent PCI. Baseline clinical, angiographic and procedural variables were used to develop the risk score in a training dataset (n=888, 70%) which was then validated in a test dataset (n=392, 30%). A credit risk assessment tool was used to construct a precise screening tool for no-reflow. Results. The model comprised age, time from pain to revascularisation, neutrophil count, admission plasma glucose level, initial TIMI flow and direct stenting as the only independent predictors of no-reflow. Each of these factors were weighted and used to develop a risk score ranging from 0 to 7. In the training dataset, the optimal threshold score for predicting no-reflow was >35, with 69% sensitivity and 81% specificity (area under the curve (AUC) = 0.84, p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }