Archives of the Turkish Society of Cardiology
Association between SYNTAX II score and electrocardiographic evidence of no-reflow in patients with ST-segment elevation myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2018; 46(6): 455-463 | DOI: 10.5543/tkda.2018.86132

Association between SYNTAX II score and electrocardiographic evidence of no-reflow in patients with ST-segment elevation myocardial infarction

Lütfü Aşkın, Erdal Aktürk
Department of Cardiology, Adıyaman Training and Research Hospital, Adıyaman, Turkey


OBJECTIVE
This study was performed to examine the association between the SYNTAX II score (SS-II) and no-reflow observed on electrocardiography and examine their use in the evaluation of risk of an in-hospital major adverse cardiovascular event (MACE) in patients with ST-segment elevation myocardial infarction (STEMI).

METHODS
A total of 126 consecutive STEMI patients who underwent primary percutaneous coronary intervention (pPCI) were recruited. The SS-II was derived using angiographic and basic patient clinical features. The difference in the sum of ST-segment elevations measured between before the pPCI and the assessment determined approximately 60 minutes after the pPCI was interpreted as the sum of ST-segment resolution (ΣSTR). MACE is a composite endpoint frequently used in cardiovascular research and usually includes endpoints reflecting safety and effectiveness. ΣSTR <50% was defined as incomplete ΣSTR (no-reflow group; n=44), while ΣSTR ≥50% was defined as complete ΣSTR (normal-flow group, n=82).

RESULTS
The SS-II was significantly higher in the no-reflow group (p<0.001). SS-II and no-reflow findings were associated with MACE. Logistic regression analysis demonstrated significant predictive values of SS-II (Odds ratio [OR]: 1.169; 95% confidence interval [CI]: 1.084–1.260; p<0.001) and ΣSTR (OR: 0.764; 95% CI: 0.632–0.924; p=0.006) for in-hospital MACE.

CONCLUSION
SS-II was significantly associated with no-reflow as assessed by electrocardiography. In patients with STEMI, SS-II and no-reflow (incomplete ΣSTR) may be important predictive factors for in-hospital MACE.

Keywords: Major adverse cardiovascular event, ST-segment elevation myocardial infarction; SYNTAX score II.

How to cite this article
Lütfü Aşkın, Erdal Aktürk. Association between SYNTAX II score and electrocardiographic evidence of no-reflow in patients with ST-segment elevation myocardial infarction. Turk Kardiyol Dern Ars. 2018; 46(6): 455-463

Corresponding Author: Lütfü Aşkın, Türkiye
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