Three indicators and postoperative intervention in elderly patients with acute STEMI research on the correlation of no reflow

AIM To explore the correlation between shock index (SI), admission plasma glucose (APG), homocysteine (HCY) and no flow after emergency percutaneous coronary intervention (PCI) in elderly patients with acute ST-segment elevation myocardial infarction (STEMI).

METHODS The clinical data of 379 elderly patients with acute STEMI who underwent emergency PCI were retrospectively analyzed. According to the TIMI blood flow after PCI, the patients were divided into no-reflow group (71 cases) and normal blood flow group (308 cases). The clinical data, angiography and intervention conditions of the two groups were compared. Multivariate logistic regression analysis was used to analyze the independent risk factors of no reflow in elderly patients with acute STEMI after emergency PCI and the receiver operating characteristic curve (ROC) was used to evaluate the prediction of no reflow in elderly patients with acute STEMI after emergency PCI.

RESULTS Compared with the normal blood flow group, the admission heart rate and SI of patients in the non reflow group were higher than those in the normal blood flow group, while the systolic and diastolic blood pressure were lower than those in the normal blood flow group, all P<0.01. White blood cell count (WBC) increased (P<0.05), the absolute value of neutrophil cell (NEUT) increased (P<0.05), red blood cell count (RBC) decreased (P<0.01), mean red cell volume (MCV) decreased (P<0.01), hemoglobin (HGB) decreased (P<0.05), C-reactive protein (CRP) increased (P<0.05), The increase of APG (P<0.05), UREA (P<0.05), HCY (P<0.01), and D-dimer (D-D) (P<0.01) showed that SI, APG, and HCY were independent risk factors for no reflow in elderly patients with acute STEMI after emergency PCI. Receiver operating characteristic analysis showed that SI+APG+HCY was superior to SI, APG, HCY, SI+APG, SI+HCY, APG+HCY in predicting no reflow after PCI in elderly patients with STEMI, and the difference was statistically significant (P<0.01).

CONCLUSION SI, APG and HCY are independent risk factors for the occurrence of no-reflow after emergency PCI in elderly patients with acute STEMI and SI+APG+HCY has a good predictive value for no-reflow after intervention.