A weight-adapted bolus (0.25 mg/kg) of abciximab (Reopro ®, Lilly Corp) was also administered in all patients, with the exception of those who received prehospital fibrinolytic therapy. Īs a pharmacological regimen, all patients received 500 mg Aspirin orally, 300 mg Clopidogrel and a weight adapted bolus of intravenous heparin (100 IE/kg) upon admission prior to entering the cathlab. All interventions were performed according to current standard guidelines. STEMI was defined as typical ischemic chest pain within the previous 12 h and ST-segment elevations of >2 mm in at least two contiguous leads.Īll patients underwent acute coronary angiography and, if eligible, direct or rescue angioplasty. Results from 500 consecutive patients treated with acute PCI in acute STEMI were retrospectively acquired. We investigated the clinical outcome at index hospitalisation and after 6 months in groups of patients with or without re-established TIMI three flow, using data from our acute PCI database of a “real world” outdoor patient cohort of 500 patients treated between February 2001 and October 2006. The benefits of reperfusion therapy have been attributed to the prompt reestablishment of normal blood flow in the infarct-related artery, defined as thrombolysis in myocardial infarction (TIMI) 3 flow. As our treatment center has a skilled PCI laboratory with an experienced interventional cardiologist on duty 24 h a day, patients admitted to our hospital undergo primary PCI if coronary arteries are suitable, as recommend in current standard guidelines within <90 min door-to-balloon time. Timely reperfusion of the infarct-related coronary artery using fibrinolysis or PCI is central to optimal STEMI treatment. Reperfusion therapy is the cornerstone of treatment for patients with acute ST-elevation myocardial infarction (STEMI). After 6 months, patients without restored normal TIMI flow had worse New York Heart Association functional class (NYHA), and had to undergo repeat coronary angiography more often. A regressions analysis showed that predictors leading to such flow patterns are diabetes ( P = 0.013), pre-hospital fibrinolytic therapy ( P = 0.017), cardiogenic shock ( P = 0.002) and a 3-vessel disease ( P = 0.003). In patients with post-interventional TIMI flow ≤ 2 the left anterior descending coronary artery (LAD) was significantly more often seen as the target vessel (54.3% Vs. 24.3% P = 0.002) and use of intra-aortic balloon pump were all more unlikely (5.8% Vs. 32.9% P < 0.0001), left ventricular ejection fraction was better (51.3 Vs. In this group, in-hospital mortality was significant lower (6.4% Vs. In 430 patients, post-interventional TIMI flow 3 could be established. 5.3☒.7, p < 0.001).ĬONCLUSIONS: The N/L ratio, which is cheaply and easily measurable laboratory data is independently associated with post primary PCI coronary no-reflow.Between 20, 500 patients underwent primary PCI for STEMI. Additionally, N/L ratio was also significantly higher in No-reflow group (TIMI Flow Grade 0, 1 or 2) group (13.1±4.5 vs. The neutrophil/lymphocyte (N/L) ratio was also significantly higher in STEMI group (7.1±4.6 vs. With respect to baseline laboratory status, fasting glucose, blood urea nitrogen, creatinine levels were not significantly different between groups. RESULTS: Diabetes mellitus hypertension and smoking status were similar between groups. No-reflow was defined as post-PCI TIMI Flow Grade 0, 1 or 2 and angiographic success was defined as TIMI Grade 3 Flow. The STEMI patients were divided into 2 groups based on the Thrombolysis In Myocardial Infarction (TIMI) flow grade. PATIENTS AND METHODS: A total of 145 consecutive STEMI patients (mean age=58.2☑2.3 years) and healthy volunteer admitted within 6 hours from symptom onset were enrolled to the study in the cardiology clinics. The aim of this study is to investigate the relationship between hematologic parameters and post primary PCI coronary no-reflow. OBJECTIVES: ST segment elevation myocardial infarction (STEMI) is an important cause of the morbidity and mortality in coronary artery disease.
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