Document Type : Original Article(s)
Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Professor, Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
General Practitioner, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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 (0 to 2). Univariate and multiple logistic regression analyses were performed to investigate factors associated with slow/no-reflow and P < 0.050 was considered as significant. RESULTS: A total of 205 patients were studied (81% man, mean ± standard deviation of age was 66.8 ± 9.6 years). Slow/no-reflow was found in 38 (18.5%) patients. High diastolic blood pressure (P = 0.010), leukocytosis (P = 0.017), diffuse lesions (P = 0.007), degenerated SVG (P < 0.001), proximal lesions (P < 0.001), thrombosis (P = 0.013), and lower number of used stents during procedure (P = 0.032) 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) = 3.858 [95% confidence interval (95% CI), 1.157-12.860], degenerated SVG with OR = 5.901 (95% CI: 1.883-18.492), proximal lesions with OR = 5.070 (95% CI: 1.822-14.113), pre-intervention TIMI grade with OR = 0.618 (95% CI: 0.405-0.942), number of used stents for PCI with OR = 0.074 (95% CI: 0.011-0.481) for > 1 stent, and length of stents used for PCI with OR = 0.100 (95% CI: 0.019-0.529) for > 30 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.
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