The Impact of Serum Rheumatoid Factor Level and No-Reflow Phenomenon in acute coronary syndrome

Objectives: to find-out how baseline blood Rheumatoid factor (RF) levels related to the no-reflow phenomenon in people who are getting primary PCI and the location of coronary-artery disease. Background: RF is an antibody against the Fc portion of immunoglobulin G, has been implicated to have an association with atherosclerosis. Primary percutaneous coronary intervention (PCI) is still the gold standard treatment of ST-segment elevation myocardial infarction (STEMI). Methods : Prospective cohort design and focused on observing 100 patients diagnosed with NSTEMI and STEMI, had primary PCI within 12hours of their first presentation, divided into 2 groups A, 50 with STEMI, and B, 50 with NSTEMI. Each group separated into two subgroups: no-reflow group (30) and reflow group (20). Results: Levels of troponin in the STEMI and NSTEMI reflow groups exhibited significant associations with RF. Negative connection was observed between the levels of RF and predischarge EF% in the no-reflow group of patients with STEMI and NSTEMI. A significant positive association was seen between the levels of RF and the variables HS, Troponin, and syntactic score in all patients. RF at cut-off >19 was found to be associated with no-reflow in STEMI & NSTEMI with 84% sensitivity, 88% specificity, 87.5 % PPV and 84.6 % NPV. Conclusion: Occurrence of no-reflow phenomenon in STEMI & NSTEMI patients after primary PCI can be predicted using Serum RF level and associated with increase SYNTAX score, hs-troponin and decreased pre discharge EF.