The Association of Plasma Osmolarity with No-Reflow in Patients with ST Elevation Myocardial Infarction: A Retrospective Cohort Study

Background: In this study, we sought to examine the statistical association of plasma osmolarity with no-reflow development in patients with ST-segment elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (pPCI). Methods: In this retrospective stud...

Full description

Saved in:
Bibliographic Details
Published in:The Eurasian journal of medicine 2024-02, Vol.56 (1), p.27-34
Main Authors: Hamideyin, Serif, Artac, Inanc
Format: Article
Language:English
Subjects:
Cardiology
Care and treatment
Clopidogrel
Comparative analysis
Dextrose
Glucose
Health aspects
Heart attack
Interventional Cardiology
Measurement
Myocardial ischemia
Original
Osmoregulation
Risk factors
Tirofiban
Transluminal angioplasty
Urea
Water-electrolyte balance (Physiology)
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: In this study, we sought to examine the statistical association of plasma osmolarity with no-reflow development in patients with ST-segment elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (pPCI). Methods: In this retrospective study, we included data from 1294 consecutive STEMI patients who have undergone pPCI. For each patient, we measured the plasma osmolarity using the following equation: 2 * sodium + 0.9 glucose + 0.93 * urea * 0.5. Results: Occurrence of angiographic no-reflow was 21.7% (n = 281) in the study. The mean plasma osmolarity level was significantly higher in patients with no-reflow compared to those without no-reflow (300.6 [+ or -] 9.4 mOsmol/L versus 292.8 [+ or -] 10.5 mOsmol/L, P < .001, respectively). In multivariate logistic regression analysis, plasma osmolarity was found to be independently related to no-reflow development (odds ratio: 1.061; 95% CI, 1.045-1.076; P < .001). According to the receiver operating characteristic curve analysis, a plasma osmolarity level greater than 290.2 mOsmol/L was identified as the optimal value for predicting the occurrence of no-reflow. This cutoff demonstrated a sensitivity of 91.8% and a specificity of 45.8%. Conclusion: This is the first study to establish an independent relationship between higher plasma osmolarity and the development of no-reflow in patients with STEMI who have undergone pPCI. This finding suggests that plasma osmolarity may be a useful marker for the prediction of no-reflow in STEMI patients who have undergone pPCI. Keywords: No-reflow phenomenon, plasma osmolarity, percutaneous coronary intervention, ST elevation myocardial infarction
ISSN:1308-8734
1308-8742
DOI:10.5152/eurasianjmed.2024.23143