Risk assessment score of no-reflow phenomenon in predicting myocardial perfusion disorders by contrast echocardiography in ST-segment elevation myocardial infarction patients after endovascular revascularization

Abstract

Aim. To study the capabilities of risk assessment score for angiographic no-reflow phenomenon in predicting myocardial perfusion disorders according to contrast echocardiography data in ST-segment elevation myocardial infarction (STEMI) patients after percutaneous coronary interventions (PCI).Material and Methods. A total of 40 STEMI patients after PCI were included in the analysis. The individual risk score for noreflow phenomenon was calculated using previously developed scale in all patients. Risk of no-reflow was assessed as high when the score was ≥ 35. All patients underwent contrast echocardiography with myocardial perfusion assessment within six hours after PCI. The clinical angiographic characteristics and in-hospital outcomes were analyzed including the lethality, myocardial infarction recurrence, and stent thrombosis rates.Results. High risk of no-reflow phenomenon was identified in 13 (32.5%) patients. The rates of angiographic no-reflow phenomenon (46.2% versus 11.1%, p = 0.038) as well as contrast-enhanced echocardiography-based myocardial perfusion disorders (61.5% versus 18.5%, p = 0.011) were significantly higher in the high-risk patient group. According to results of ROCanalysis, no-reflow risk assessment scale for identifying patients with myocardial perfusion disorders according to contrast echocardiography had sensitivity/specificity/area under the curve (AUC) of 62%/85%/0.789 (p = 0.003).Conclusions. Angiographic no-reflow risk assessment score allowed to identify patients with high risk of developing myocardial perfusion disorders according to contrast echocardiography.