Abstract:

Purpose: Percutaneous coronary injection (PKG) is a treatment method in patients with ST-up myocardial infarction (STYMI). One of the best known complications of PKG is no-reflow. Studies have shown the relationship between endothelial dysfunction and vascular structure angulation caused by damaged vascular flow. Although we know about the relationship between hemodynamic changes and coronary opening, there is a lack of detailed analysis in terms of hemodynamic changes between vascular geometry and coronary stream. We aimed at illuminating the relationship between vascular geometry and no-reflow in coronates. Method: We reviewed the PKG database of our hospital and recorded 120 STYMI patients who developed no-reflow after PKG and also matched gender and age with 80 normal flows. Demographic and clinical characteristics, laboratory values and two-dimensional quantitative coronary angiography measurements for each group were assessed. Results: No-reflow patients had higher hypertension and diabetes mellitus prevalence. In addition, serum C-reactive protein levels were higher in patients developing no-reflow compared to patients with normal flow (p<0,001). On the other hand, serum hemoglobin levels were significantly lower in patients developing no-reflow compared to patients with normal flow (p<0,001). According to three-dimensional coronary measurements, the calculated breakdown angle of the left front-down artery (LAD) and circumflex artery (CX) was significantly broader in the no-reflow group compared to the control group [110,9° (21,8°) vs. 85,9° (15,8°), p<0,001]. The result: Our data showed that there was a strong relationship between the bifurcation angle of LAD-CX and the no-reflow phenomenon in STYMI patients applied to PKG.

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