Left circumflex coronary artery is protected against no-reflow phenomenon following percutaneous coronary intervention for coronary artery disease

作者：Nagai Toshiyuki^*; Hirano Takuro; Tsunoda Mayumi; Hosaka Haruhiko; Kishino Yoshikazu; Katayama Takaharu; Matsumura Keisuke; Miyagawa Takashi; Kohsaka Shun; Anzai Toshihisa; Fukuda Keiichi; Suzuki Masahiro

来源：Heart and Vessels, 2013, 28(5): 559-565.

DOI：10.1007/s00380-012-0281-2

• Coronary artery disease
• No-reflow phenomenon
• Percutaneous coronary intervention
• Target vessel

Despite the positive impact of percutaneous coronary intervention (PCI) on reducing mortality, a small percentage of patients experience poor myocardial reperfusion following PCI. However, factors associated with no-reflow remain unclear. We investigated clinical factors associated with no-reflow following PCI for coronary artery disease (CAD). We retrospectively analyzed 1622 consecutive CAD patients who underwent PCI over a 5-year period at our institution. Patients were divided into two groups according to the presence (n = 31) or absence (n = 1591) of no-reflow, defined as Thrombolysis in Myocardial Infarction flow grade < 3 after PCI. No significant differences in patient characteristics or PCI strategy were seen between the no-reflow and normal flow groups. The incidence of no-reflow was significantly lower in the left circumflex artery (LCx) than in the left anterior descending artery (LAD) (P = 0.0015), with no differences in characteristics or PCI strategy between these two target vessels. Multivariate analysis revealed that involvement of the LCx was an independent protective factor against no-reflow (odds ratio 0.14, 95 % confidence interval 0.02-0.98, P = 0.044). In conclusion, LCx as the target vessel was protective against no-reflow compared with LAD following PCI for CAD. Our results suggest that embolic protection devices may be unnecessary in CAD patients with involvement of LCx.

• 出版日期2013-9