Metabolic syndrome is a predictor for an ECG sign of no-reflow after primary PCI in patients with acute ST-elevation myocardial infarction

Nutr Metab Cardiovasc Dis. 2008 Jul;18(6):441-7. doi: 10.1016/j.numecd.2007.02.015. Epub 2007 Nov 5.

Abstract

Background and aim: The purpose of this study was to evaluate both the predictive value of metabolic syndrome (MS) on no-reflow phenomenon and 30-day clinical outcomes on patients undergoing primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (STEMI).

Methods and results: One hundred and twelve consecutive patients (mean age 57+/-11 years, 94 male) with acute STEMI treated with primary PCI were analysed prospectively. Sum of ST-segment elevation was obtained immediately before and 60 min after the restoration of TIMI-3 flow. The difference between two measurements was accepted as the amount of ST-segment resolution and was expressed as summation operatorSTR. summation operatorSTR<50% was accepted as ECG sign of no-reflow phenomenon. Metabolic syndrome was defined based on Adult Treatment Panel-III criteria. The no-reflow was found in 22.3% of the entire group and was significantly higher in patients with MS than those without MS (43.7% vs. 13.7%, p<0.001). There was no significant difference in no-reflow between patients who had both MS and diabetes mellitus (DM) and patients who had MS but not DM (42.5% vs. 50%, respectively; p>0.05).

Conclusion: The presence of MS may play an important role in the occurrence of no- reflow in STEMI treated with primary PCI.

MeSH terms

  • Angioplasty, Balloon, Coronary*
  • Coronary Circulation
  • Electrocardiography / methods*
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Myocardial Infarction / physiopathology*
  • Myocardial Infarction / therapy*
  • No-Reflow Phenomenon / epidemiology
  • No-Reflow Phenomenon / etiology*
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome