Metabolic predictors of no-reflow in diabetic STEMI patients undergoing primary percutaneous coronary intervention

Abstract Objectives The aim of the work was to examine the link between selected metabolic risk factors and the incidence of the no-reflow phenomenon in diabetic individuals undergoing primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI). Methods This prospective cross-sectional investigation was conducted on 120 diabetic participants aged 18 or older, of both sexes, who presented with ST-elevation myocardial infarction (STEMI) and underwent PPCI. Two groups were formed based on participant characteristics: Group I (normal-reflow), defined by thrombolysis in myocardial infarction (TIMI) grade 3 flow, and Group II (no-reflow), characterized by TIMI flow ≤2, which is not attributed to dissection, residual vessel narrowing, or vasospasm. Results Results from univariate regression indicated that age, hypertension, and dyslipidemia were significantly linked to the development of the no-reflow phenomenon (P< 0.05). In addition, systolic blood pressure (SBP), diastolic blood pressure, platelet count, high-density lipoprotein, triglycerides, serum urea, uric acid, and glomerular filtration rate (GFR) were significant predictors of no-reflow (P<0.05). After a regression model incorporating multiple variables indicated that SBP and platelet count independently predicted no-reflow (P<0.05). Regarding clinical outcomes, the incidence of heart failure and atrial fibrillation was significantly higher in the no-reflow group (P<0.05). Conclusions No-reflow is a common adverse event observed in diabetic individuals presenting with STEMI who undergo PPCI. It is influenced by a combination of clinical and biochemical risk factors, including advanced age, smoking, hypertension, dyslipidemia, impaired renal function, elevated serum uric acid, and reduced GFR.