Factors associated with the no-reflow phenomenon following percutaneous intervention of saphenous vein coronary bypass grafts

BACKGROUND: We investigated clinical and procedural factors associated with the no-reflow phenomenon following percutaneous coronary intervention (PCI) of the saphenous-vein grafts (SVG). METHODS: A cross-sectional study was done on patients who had undergone PCI of the SVG. Patients’ medical documents were reviewed for demographic, clinical, laboratory, and procedural data. Slow/no-reflow was defined based on the thrombolysis in myocardial infarction (TIMI) grade (۰ to ۲). Univariate and multiple logistic regression analyses were performed to investigate factors associated with slow/no-reflow and P < ۰.۰۵۰ was considered as significant. RESULTS: A total of ۲۰۵ patients were studied (۸۱% man, mean ± standard deviation of age was ۶۶.۸ ± ۹.۶ years). Slow/no-reflow was found in ۳۸ (۱۸.۵%) patients. High diastolic blood pressure (P = ۰.۰۱۰), leukocytosis (P = ۰.۰۱۷), diffuse lesions (P = ۰.۰۰۷), degenerated SVG (P < ۰.۰۰۱), proximal lesions (P < ۰.۰۰۱), thrombosis (P = ۰.۰۱۳), and lower number of used stents during procedure (P = ۰.۰۳۲) were associated with slow/no-reflow in unadjusted analyses. Factors independently associated with slow/no-reflow were pre-procedural high diastolic blood pressure with odds ratio (OR) = ۳.۸۵۸ [۹۵% confidence interval (۹۵% CI), ۱.۱۵۷-۱۲.۸۶۰], degenerated SVG with OR = ۵.۹۰۱ (۹۵% CI: ۱.۸۸۳-۱۸.۴۹۲), proximal lesions with OR = ۵.۰۷۰ (۹۵% CI: ۱.۸۲۲-۱۴.۱۱۳), pre-intervention TIMI grade with OR = ۰.۶۱۸ (۹۵% CI: ۰.۴۰۵-۰.۹۴۲), number of used stents for PCI with OR = ۰.۰۷۴ (۹۵% CI: ۰.۰۱۱-۰.۴۸۱) for > ۱ stent, and length of stents used for PCI with OR = ۰.۱۰۰ (۹۵% CI: ۰.۰۱۹-۰.۵۲۹) for > ۳۰ mm stents. CONCLUSION: This study on the clinical and procedural factors associated with the slow/no-reflow phenomenon following PCI of the SVG can be used in risk estimation of this serious complication and tailoring preventive strategies to at-risk patients.   

کلیدواژه ها:

Angioplasty ، Coronary Artery Bypass ، No-Reflow Phenomenon ، Percutaneous Coronary Intervention ، Saphenous Vein