Background: Coronary no-reflow phenomenon is a well-known complication that is associated with poor prognosis in patients with ST-elevation MI (STEMI). However, the pathophysiology of no-reflow is complicated and it is challenging to develop effective treatment strategies. In this study, we aimed to reveal the association between admission glucose level and coronary no-reflow in patients with STEMI treated by primary percutaneous coronary intervention (PCI).
Methods: We chose patients with STEMI who were treated by primary PCI. No-reflow was defined by angiographic TIMI flow grade (≤2). Univariable and multivariable logic regression analysis was used to reveal the association between predictors and no-reflow phenomenon.
Results: A total of 542 patients were selected (mean age 60 ± 14 years, men 84%). After primary PCI, coronary no-reflow developed in 48 patients (8.9%). Univariable logic regression revealed the possible predictors of coronary no-reflow phenomenon as age (OR 1.04, 95% CI [1.02–1.06], p<0.001), systolic blood pressure (OR 0.99, 95% CI [0.98–0.99], p<0.01), diastolic blood pressure (OR 0.99, 95% CI [0.98–0.99], p<0.05), current smoker (OR 0.56, 95% CI [0.30–1.05], p=0.07), admission glucose level (OR 1.07, 95% CI [1.03–1.11], p<0.001), total occlusion (OR 1.92, 95% CI [0.93–3.95], p=0.08) and culprit artery initial TIMI flow grade (OR 0.67, 95% CI [0.46–0.97], p<0.05). After adjustment for these variables, age (OR 1.05, 95% CI [1.02–1.08], p<0.001), systolic blood pressure (OR 0.98, 95% CI [0.96–0.99], p<0.05) and admission glucose level (OR 1.07, 95% CI [1.02–1.12], p<0.01) were independent predictors of coronary no-reflow phenomenon.
Conclusion: Pathophysiology of coronary no-reflow phenomenon after primary PCI is multifactorial. Admission glucose level is an independent and strong predictor of coronary no-reflow in patients with STEMI.