Association between SYNTAX score-II and no-reflow in patients with acute anterior ST-segment elevation myocardial infarction

Abstract

Background and objectives: The no-reflow phenomenon associated with cardiovascular mortality is one of the serious complications of percutaneous coronary intervention. Also, having both clinical and angiographic parameters, SYNTAX score-II (SS-II) predicts mortality in patients with acute coronary syndrome (ACS). The aim of this study is to investigate the association of the no-reflow phenomenon with SS-II. Subjects and methods: 255 consecutive participants (210 [82.3%] male, median age; 55 [18–90] with acute anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention were enrolled in the study. Patients were divided into two groups as follows: those with no-reflow and those with reflow. Demographic features, comorbidities, biochemical parameters were recorded. SYNTAX score-I (SS-I), and SS-II of the patients were calculated. Results: No-reflow group was older. Hypertension was more frequent in the no-reflow group than that of the re-flow group (p = 0.007). Troponin levels (both on admission and peak), TIMI frame count, SS-I, and SS-II were significantly higher in patients with no-reflow. In logistic regression analysis, SS-II (odds ratio [OR]: 1.096, 95% confidence interval [CI]: 1.058–1.135; p< 0.001) was independently associated with the no-reflow phenomenon. A cut-off value of ≥ 24.85 predicted no-reflow, with 75.9% sensitivity and 59.2% specificity (AUC: 0.721 [0.637–0.805], 95% CI, p< 0.001) in ROC curve analysis. Conclusion: In STEMI patients, particularly acute anterior MI, SS-II is independently associated with the no-reflow phenomenon, which is a fatal and frequent complication of ACS.