Turk Kardiyol Dern Ars. Ahead of Print: TKDA-86132 | DOI: 10.5543/tkda.2018.86132
Association between the Syntax Score II and Electrocardiographic Evidence of No-Reflow in Patients with ST Segment Elevation Myocardial Infarction
, Erdal Aktürk
Adiyaman University Education and Research Hospital
OBJECTIVE This study was performed to examine the association between SYNTAX score II (SS-II) and no-reflow on electrocardiography and the accuracy of two scores for determination of in-hospital major adverse cardiovascular events (MACE) in patients with ST-segment elevation myocardial infarction(STEMI).
METHODS A total of 126 consecutive STEMI patients with primary percutaneous coronary intervention (pPCI) were recruited. SS-II was derived using angiographic and basic patient clinical features. The difference in the sum of ST segment elevations that were measured between before pPCI and that determined approximately 60 minutes later after pPCI was interpreted as the sum of ST-segment resolution (ΣSTR). MACE is a composite endpoint frequently used in cardiovascular research and usually includes end points reflecting safety and effectiveness. ΣSTR < 50% was defined as incomplete ΣSTR (no-reflow, n = 44), while ΣSTR ≥ 50% was defined as complete ΣSTR (normal-flow, n = 82).
RESULTS SS-II was significantly higher in the no-reflow group (p < 0.001). SS-II and no-reflow were associated with MACE. Logistic regression analysis demonstrated significant predictive values of SS-II (OR = 1.169, 95% 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.
CONCLUSIONS 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.
major adverse cardiovascular events, SYNTAX score II, ST segment elevation myocardial infarction
How to cite this article
Corresponding Author: Lütfü Aşkın, Türkiye