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

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Abstract

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.

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Acknowledgments

We thank our medical assistants (NHO Saitama Hospital) for collecting the clinical data and Eiichi Sekizuka (Head of NHO Saitama Hospital) for supporting our research.

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Authors and Affiliations

  1. Department of Cardiology, National Hospital Organization, Saitama Hospital, Saitama, Japan

    Toshiyuki Nagai, Takuro Hirano, Mayumi Tsunoda, Haruhiko Hosaka, Takaharu Katayama, Keisuke Matsumura, Takashi Miyagawa & Masahiro Suzuki

  2. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Toshiyuki Nagai & Toshihisa Anzai

  3. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan

    Yoshikazu Kishino, Shun Kohsaka & Keiichi Fukuda

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  1. Toshiyuki Nagai
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  2. Takuro Hirano
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Correspondence to Toshiyuki Nagai.

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Nagai, T., Hirano, T., Tsunoda, M. et al. Left circumflex coronary artery is protected against no-reflow phenomenon following percutaneous coronary intervention for coronary artery disease. Heart Vessels 28, 559–565 (2013). https://doi.org/10.1007/s00380-012-0281-2

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  • DOI: https://doi.org/10.1007/s00380-012-0281-2

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