Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry
© 2018 Europa Digital & Publishing. All rights reserved. Aims: The aim of the study was to evaluate long-term outcomes of transient versus persistent no-reflow. Methods and results: A total of 17,547 patients with normal flow post percutaneous coronary intervention (PCI) were compared to 590 p...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Conference Paper |
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ELSEVIER SCIENCE INC
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/69498 |
| _version_ | 1848762057722167296 |
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| author | Papapostolou, S. Andrianopoulos, N. Duffy, S. Brennan, Angela Ajani, A. Clark, D. Reid, C. Freeman, M. Sebastian, M. Selkrig, L. Yudi, M. Noaman, S. Chan, W. |
| author_facet | Papapostolou, S. Andrianopoulos, N. Duffy, S. Brennan, Angela Ajani, A. Clark, D. Reid, C. Freeman, M. Sebastian, M. Selkrig, L. Yudi, M. Noaman, S. Chan, W. |
| author_sort | Papapostolou, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2018 Europa Digital & Publishing. All rights reserved. Aims: The aim of the study was to evaluate long-term outcomes of transient versus persistent no-reflow. Methods and results: A total of 17,547 patients with normal flow post percutaneous coronary intervention (PCI) were compared to 590 patients (3.2%) with transient no-reflow and 144 patients (0.8%) with persistent no-reflow. Long-term all-cause mortality was obtained by linkage with the National Death Index (NDI). No-reflow patients were more likely to have presented with ST-elevation myocardial infarction (STEMI), out-of-hospital cardiac arrest (OHCA) or cardiogenic shock (all p<0.01). Long-term NDI-linked all-cause mortality was highest in patients with persistent no-reflow (31%) followed by transient no-reflow (22%) and normal flow (14%) over a median follow-up of 5.2, 5.5 and 4.5 years, respectively (all p<0.0001). Kaplan-Meier survival estimates demonstrated a graded increase in all-cause mortality from normal flow, to transient to persistent no-reflow (p<0.01), with the highest mortality occurring early (<30 days) in the persistent no-reflow group (p<0.0001). Multivariate Cox proportional hazards modelling identified glomerular filtration rate <30 mL/min, ejection fraction <30%, persistent no-reflow and transient no-reflow as independent predictors of increased hazard for all-cause mortality (all p<0.05). Conclusions: Transient and persistent no-reflow were associated with a stepwise reduction in long-term survival. The presence of even transient no-reflow appears to be an important predictor of adverse long-term outcome. |
| first_indexed | 2025-11-14T10:41:31Z |
| format | Conference Paper |
| id | curtin-20.500.11937-69498 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:41:31Z |
| publishDate | 2018 |
| publisher | ELSEVIER SCIENCE INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-694982018-08-08T04:56:26Z Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry Papapostolou, S. Andrianopoulos, N. Duffy, S. Brennan, Angela Ajani, A. Clark, D. Reid, C. Freeman, M. Sebastian, M. Selkrig, L. Yudi, M. Noaman, S. Chan, W. © 2018 Europa Digital & Publishing. All rights reserved. Aims: The aim of the study was to evaluate long-term outcomes of transient versus persistent no-reflow. Methods and results: A total of 17,547 patients with normal flow post percutaneous coronary intervention (PCI) were compared to 590 patients (3.2%) with transient no-reflow and 144 patients (0.8%) with persistent no-reflow. Long-term all-cause mortality was obtained by linkage with the National Death Index (NDI). No-reflow patients were more likely to have presented with ST-elevation myocardial infarction (STEMI), out-of-hospital cardiac arrest (OHCA) or cardiogenic shock (all p<0.01). Long-term NDI-linked all-cause mortality was highest in patients with persistent no-reflow (31%) followed by transient no-reflow (22%) and normal flow (14%) over a median follow-up of 5.2, 5.5 and 4.5 years, respectively (all p<0.0001). Kaplan-Meier survival estimates demonstrated a graded increase in all-cause mortality from normal flow, to transient to persistent no-reflow (p<0.01), with the highest mortality occurring early (<30 days) in the persistent no-reflow group (p<0.0001). Multivariate Cox proportional hazards modelling identified glomerular filtration rate <30 mL/min, ejection fraction <30%, persistent no-reflow and transient no-reflow as independent predictors of increased hazard for all-cause mortality (all p<0.05). Conclusions: Transient and persistent no-reflow were associated with a stepwise reduction in long-term survival. The presence of even transient no-reflow appears to be an important predictor of adverse long-term outcome. 2018 Conference Paper http://hdl.handle.net/20.500.11937/69498 10.4244/EIJ-D-17-00269 ELSEVIER SCIENCE INC restricted |
| spellingShingle | Papapostolou, S. Andrianopoulos, N. Duffy, S. Brennan, Angela Ajani, A. Clark, D. Reid, C. Freeman, M. Sebastian, M. Selkrig, L. Yudi, M. Noaman, S. Chan, W. Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry |
| title | Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry |
| title_full | Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry |
| title_fullStr | Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry |
| title_full_unstemmed | Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry |
| title_short | Long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (PCI): A multicentre Australian registry |
| title_sort | long-term clinical outcomes of transient and persistent no-reflow following percutaneous coronary intervention (pci): a multicentre australian registry |
| url | http://hdl.handle.net/20.500.11937/69498 |