Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction

Katsuomi Iwakura, Hiroshi Itoh, Shigeo Kawano, Yasunori Shintani, Koichi Yamamoto, Akinobu Kato, Masashi Ikushima, Koji Tanaka, Masashi Kitakaze, Masatsugu Hori, Yorihiko Higashino, Kenshi Fujii

Research output: Contribution to journalArticle

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Abstract

OBJECTIVES: We sought to elucidate the clinical factors related to the development of no-reflow phenomenon after successful coronary reperfusion in patients with an acute myocardial infarction (AMI). BACKGROUND: Myocardial contrast echocardiography revealed that the no-reflow phenomenon is observed in some patients with a reperfused AMI, and those patients usually have poor functional and clinical outcomes. It is still unknown what clinical factors are related to the development of the no-reflow phenomenon. METHODS: Myocardial contrast echocardiography was performed 15 min after successful coronary reperfusion therapy in 199 patients with an anterior wall AMI who underwent successful coronary reperfusion with primary coronary angioplasty within 24 h after the onset of AMI. Multiple logistic regression analysis was used to identify independent predictors of the no-reflow phenomenon. RESULTS: Seventy-nine patients showed the no-reflow phenomenon. Univariate analysis indicated that pre-infarction angina within 48 h before symptom onset, Killip class, Thrombolysis in Myocardial Infarction flow grade 0 on the initial coronary angiogram, the number of abnormal Q-waves and the wall motion score (WMS) on the echocardiogram obtained at hospital admission are related to the no-reflow phenomenon. Multivariate logistic regression analysis revealed that all of these factors, except for Killip class, are independent predictive factors of the no-reflow phenomenon. CONCLUSIONS: Development of the no-reflow phenomenon is related to the severity of myocardial damage (number of Q-waves), the size of the risk area (WMS) and the occlusion status of infarct-related artery. In addition, ischemic preconditioning (pre-infarction angina) seems to be the factor that attenuates the no-reflow phenomenon.

Original languageEnglish
Pages (from-to)472-477
Number of pages6
JournalJournal of the American College of Cardiology
Volume38
Issue number2
DOIs
Publication statusPublished - 2001
Externally publishedYes

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No-Reflow Phenomenon
Anterior Wall Myocardial Infarction
Myocardial Reperfusion
Myocardial Infarction
Infarction
Echocardiography
Logistic Models
Regression Analysis
Ischemic Preconditioning
Angioplasty
Angiography
Arteries

ASJC Scopus subject areas

  • Nursing(all)

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Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction. / Iwakura, Katsuomi; Itoh, Hiroshi; Kawano, Shigeo; Shintani, Yasunori; Yamamoto, Koichi; Kato, Akinobu; Ikushima, Masashi; Tanaka, Koji; Kitakaze, Masashi; Hori, Masatsugu; Higashino, Yorihiko; Fujii, Kenshi.

In: Journal of the American College of Cardiology, Vol. 38, No. 2, 2001, p. 472-477.

Research output: Contribution to journalArticle

Iwakura, K, Itoh, H, Kawano, S, Shintani, Y, Yamamoto, K, Kato, A, Ikushima, M, Tanaka, K, Kitakaze, M, Hori, M, Higashino, Y & Fujii, K 2001, 'Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction', Journal of the American College of Cardiology, vol. 38, no. 2, pp. 472-477. https://doi.org/10.1016/S0735-1097(01)01405-X
Iwakura, Katsuomi ; Itoh, Hiroshi ; Kawano, Shigeo ; Shintani, Yasunori ; Yamamoto, Koichi ; Kato, Akinobu ; Ikushima, Masashi ; Tanaka, Koji ; Kitakaze, Masashi ; Hori, Masatsugu ; Higashino, Yorihiko ; Fujii, Kenshi. / Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction. In: Journal of the American College of Cardiology. 2001 ; Vol. 38, No. 2. pp. 472-477.
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abstract = "OBJECTIVES: We sought to elucidate the clinical factors related to the development of no-reflow phenomenon after successful coronary reperfusion in patients with an acute myocardial infarction (AMI). BACKGROUND: Myocardial contrast echocardiography revealed that the no-reflow phenomenon is observed in some patients with a reperfused AMI, and those patients usually have poor functional and clinical outcomes. It is still unknown what clinical factors are related to the development of the no-reflow phenomenon. METHODS: Myocardial contrast echocardiography was performed 15 min after successful coronary reperfusion therapy in 199 patients with an anterior wall AMI who underwent successful coronary reperfusion with primary coronary angioplasty within 24 h after the onset of AMI. Multiple logistic regression analysis was used to identify independent predictors of the no-reflow phenomenon. RESULTS: Seventy-nine patients showed the no-reflow phenomenon. Univariate analysis indicated that pre-infarction angina within 48 h before symptom onset, Killip class, Thrombolysis in Myocardial Infarction flow grade 0 on the initial coronary angiogram, the number of abnormal Q-waves and the wall motion score (WMS) on the echocardiogram obtained at hospital admission are related to the no-reflow phenomenon. Multivariate logistic regression analysis revealed that all of these factors, except for Killip class, are independent predictive factors of the no-reflow phenomenon. CONCLUSIONS: Development of the no-reflow phenomenon is related to the severity of myocardial damage (number of Q-waves), the size of the risk area (WMS) and the occlusion status of infarct-related artery. In addition, ischemic preconditioning (pre-infarction angina) seems to be the factor that attenuates the no-reflow phenomenon.",
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T1 - Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction

AU - Iwakura, Katsuomi

AU - Itoh, Hiroshi

AU - Kawano, Shigeo

AU - Shintani, Yasunori

AU - Yamamoto, Koichi

AU - Kato, Akinobu

AU - Ikushima, Masashi

AU - Tanaka, Koji

AU - Kitakaze, Masashi

AU - Hori, Masatsugu

AU - Higashino, Yorihiko

AU - Fujii, Kenshi

PY - 2001

Y1 - 2001

N2 - OBJECTIVES: We sought to elucidate the clinical factors related to the development of no-reflow phenomenon after successful coronary reperfusion in patients with an acute myocardial infarction (AMI). BACKGROUND: Myocardial contrast echocardiography revealed that the no-reflow phenomenon is observed in some patients with a reperfused AMI, and those patients usually have poor functional and clinical outcomes. It is still unknown what clinical factors are related to the development of the no-reflow phenomenon. METHODS: Myocardial contrast echocardiography was performed 15 min after successful coronary reperfusion therapy in 199 patients with an anterior wall AMI who underwent successful coronary reperfusion with primary coronary angioplasty within 24 h after the onset of AMI. Multiple logistic regression analysis was used to identify independent predictors of the no-reflow phenomenon. RESULTS: Seventy-nine patients showed the no-reflow phenomenon. Univariate analysis indicated that pre-infarction angina within 48 h before symptom onset, Killip class, Thrombolysis in Myocardial Infarction flow grade 0 on the initial coronary angiogram, the number of abnormal Q-waves and the wall motion score (WMS) on the echocardiogram obtained at hospital admission are related to the no-reflow phenomenon. Multivariate logistic regression analysis revealed that all of these factors, except for Killip class, are independent predictive factors of the no-reflow phenomenon. CONCLUSIONS: Development of the no-reflow phenomenon is related to the severity of myocardial damage (number of Q-waves), the size of the risk area (WMS) and the occlusion status of infarct-related artery. In addition, ischemic preconditioning (pre-infarction angina) seems to be the factor that attenuates the no-reflow phenomenon.

AB - OBJECTIVES: We sought to elucidate the clinical factors related to the development of no-reflow phenomenon after successful coronary reperfusion in patients with an acute myocardial infarction (AMI). BACKGROUND: Myocardial contrast echocardiography revealed that the no-reflow phenomenon is observed in some patients with a reperfused AMI, and those patients usually have poor functional and clinical outcomes. It is still unknown what clinical factors are related to the development of the no-reflow phenomenon. METHODS: Myocardial contrast echocardiography was performed 15 min after successful coronary reperfusion therapy in 199 patients with an anterior wall AMI who underwent successful coronary reperfusion with primary coronary angioplasty within 24 h after the onset of AMI. Multiple logistic regression analysis was used to identify independent predictors of the no-reflow phenomenon. RESULTS: Seventy-nine patients showed the no-reflow phenomenon. Univariate analysis indicated that pre-infarction angina within 48 h before symptom onset, Killip class, Thrombolysis in Myocardial Infarction flow grade 0 on the initial coronary angiogram, the number of abnormal Q-waves and the wall motion score (WMS) on the echocardiogram obtained at hospital admission are related to the no-reflow phenomenon. Multivariate logistic regression analysis revealed that all of these factors, except for Killip class, are independent predictive factors of the no-reflow phenomenon. CONCLUSIONS: Development of the no-reflow phenomenon is related to the severity of myocardial damage (number of Q-waves), the size of the risk area (WMS) and the occlusion status of infarct-related artery. In addition, ischemic preconditioning (pre-infarction angina) seems to be the factor that attenuates the no-reflow phenomenon.

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JF - Journal of the American College of Cardiology

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