Risk factors of coronary microvascular obstruction

Background Coronary microvascular obstruction /no-reflow(CMVO/NR) is a predictor of long-term mortality in survivors of ST elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PPCI). Objective To identify risk factors of CMVO/NR during PPCI. Methods Totally 2384 STEMI patients treated with PPCI were divided into two groups according to thrombolysis in myocardial infarction(TIMI) flow grade:CMVO/NR group(246cases, TIMI 0-2 grade) and control group(2138 cases, TIMI 3 grade). We used univariable and multivariable logistic regression to identify risk factors of CMVO/NR during PPCI. Results A frequency of CMVO/NR was 10.3%(246/2384). Logistic regression analysis showed that the differences between the two groups in age(unadjusted odds ratios [OR] 1.032; 95% CI, 1.02 to 1.045; adjusted OR 1.032; 95% CI, 1.02 to 1.046; P <0.001), periprocedural bradycardia (unadjusted OR 2.357; 95% CI, 1.752 to 3.171; adjusted OR1.818; 95% CI, 1.338 to 2.471; P <0.001),using thrombus aspiration devices during operation (unadjusted OR 2.489; 95% CI, 1.815 to 3.414; adjusted OR1.835; 95% CI, 1.291 to 2.606; P =0.001),neutrophil percentage (unadjusted OR 1.028; 95% CI, 1.014 to 1.042; adjusted OR1.022; 95% CI, 1.008 to 1.036; P =0.002), and total occlusion of the culprit vessel (unadjusted OR 2.626; 95% CI, 1.85 to 3.728; adjusted-OR 1.656;95% CI, 1.119 to 2.45; P =0.012) were statistically significant (P <0. 05). The area under the receiver operating characteristic curve was 0.6896 Conclusions Age, periprocedural bradycardia, using thrombus aspiration devices during operation, neutrophil percentage, and total occlusion of the culprit vessel may be independent risk factors for predicting CMVO/NR during PPCI. We registered this study with WHO International Clinical Trials Registry Platform (ICTRP) (registration number: ChiCTR1900023213; registered date: 16 May 2019).. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial ChiCTR1900023213 ### Funding Statement None. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethic committee approved the study. Approved No. of ethic committee: 2019013X. Name of the ethic committee : Ethics committee of Beijing Anzhen Hospital Capital Medical University.It was a retrospective analysis and informed consent was waived by Ethics Committee of Beijing Anzhen Hospital Capital Medical University. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The data used to support the findings of this study are included within the supplementary information file. The data are demographic, clinical, and angiographic characteristics of patients with acute STEMI during PPCI. AH= History of angina; AGE= age; TOCV=total occlusion of the culprit vessel; CNR=CMVO/NR; DH= history of diabetes; H=hemoglobin; HH = history of hypertension; IH= introperative hypotension; LAD= the culprit vessel was left anterior descending coronary artery; LCX= the culprit vessel was left circumflex coronary artery; MIH=history of myocardial infarction; NP=neutrophil percentage; PB=periprocedural bradycardia; PCIH=history of percutaneous coronary intervention; RCA= the culprit vessel was right coronary artery; S = sex; TA=using thrombus aspirationdevices during operation; TBMIPPCI =the time between myocardial infarction and PPCI.