Risk factors of coronary microvascular obstruction

Background Coronary microvascular obstruction /no-reflow(CMVO/NR) is a predictor of long-term mortality in survivors of ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PPCI). Objective To identify risk factors of CMVO/NR. Methods Totally 2384 STEMI patients treated with PPCI were divided into two groups according to thrombolysis in myocardial infarction(TIMI) flow grade:CMVO/NR group(246cases, TIMI 0-2 grade) and control group(2138 cases, TIMI 3 grade). We used univariable and multivariable logistic regression to identify risk factors of CMVO/NR. Results A frequency of CMVO/NR was 10.3%(246/2384). Logistic regression analysis showed that the differences between the two groups in age(unadjusted odds ratios [OR] 1.032; 95% CI, 1.02 to 1.045; adjusted OR 1.032; 95% CI, 1.02 to 1.046; P <0.001), periprocedural bradycardia (unadjusted OR 2.357; 95% CI, 1.752 to 3.171; adjusted OR1.818; 95% CI, 1.338 to 2.471; P <0.001),using thrombus aspirationdevices during operation (unadjusted OR 2.489; 95% CI, 1.815 to 3.414; adjusted OR1.835; 95% CI, 1.291 to 2.606; P =0.001), neutrophil percentage (unadjusted OR 1.028; 95% CI, 1.014 to 1.042; adjusted OR1.022; 95% CI, 1.008 to 1.036; P =0.002), and completely block of culprit vessel (unadjusted OR 2.626; 95% CI, 1.85 to 3.728; adjusted-OR 1.656;95% CI, 1.119 to 2.45; P =0.012) were statistically significant (P <0. 05). The area under the receiver operating characteristic curve was 0.6896. Conclusions Age, periprocedural bradycardia, using thrombus aspirationdevices during operation, neutrophil percentage, and completely block of culprit vessel may be independent risk factors for predicting CMVO/NR. We registered this study with WHO International Clinical Trials Registry Platform (ICTRP) (registration number: ChiCTR1900023213; registered date: 16 May 2019). http://www.chictr.org.cn/edit.aspx?pid=39057&htm=4 .