Effect of no-reflow/reflow on P-wave time indexes in patients with acute myocardial infarction undergoing percutaneous coronary intervention

Abstract

Aim: The aim of this study was to investigate the relationship between no-reflow (no-RF), reflow (RF), and the P-wave time index in patients undergoing percutaneous coronary intervention (PCI) with a diagnosis of acute myocardial infarction (AMI) due to total occlusion. Methods: This study included a total of 272 AMI patients with no-RF (110 patients) and RF (162 patients). Results: The no-RF group had higher values of mean maxPWTpostPCI(94.95 ± 15.61 vs. 117.86 ± 12.06, P < 0.001), minPWTpostPCI(54.21 ± 12.13 vs. 67.31 ± 11.79, P < 0.001), and PWDpostPCI(39.14 ± 12.55 vs. 50.91 ± 11.9, P < 0.001) during the post-PCI period. According to multivariate logistic regression analysis, maxPWTpostPCI(odds ratio [OR]: 1.103, 95% confidence interval [CI]: 1.049–1.160, P < 0.001), minPWTpostPCI(OR: 1.055, 95% CI: 1.011–1.101, P = 0.0014), and PWDpostPCI(OR: 1.107, 95% CI: 1.037–1.181, P = 0.002) were the independent predictors of RF after PCI. ROC curve analyses demonstrated that the optimal cutoff values for maxPWTpostPCI, minPWTpostPCI, and PWDpostPCIfor predicting no-RF were 112.95 ms (area under the curve [AUC]: 0.852, 95% CI: 0.807–0.898, P < 0.001, sensitivity 70%, specificity 85.2%), 62.66 ms (AUC: 0.650, 95% CI: 0.585–0.716, P < 0.001, sensitivity 54.5%, specificity 72.8%), and 43.43 ms (AUC: 0.782, 95% CI: 0.727–0.837, P < 0.001, sensitivity 75.5%, specificity 60.5%), respectively. Conclusions: Prolonged maxPWTpostPCI, maxPWTpostPCI,and PWDpostPCIare independent predictors that differentiate no-RF from RF in patients with AMI after PCI and can be used in the follow-up of no-RF patients during the post-PCI period.

Keywords

• acute myocardial infarction
• no-reflow
• p-wave dispersion
• p-wave time
• reflow