PREDICTIVE VALUE OF THE NORPACS SCORE AND MANAGEMENT OUTCOMES OF NO-REFLOW DURING PRIMARY PERCUTANEOUS CORONARY INTERVENTION FOR ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION
Main Article Content
Abstract
Background: The no-reflow phenomenon frequently occurs in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) and is associated with increased post-infarction complications and poor clinical outcomes. Early identification of patients at high risk of suboptimal myocardial reperfusion and optimal management of this adverse event are therefore essential. Objectives: To determine the incidence, evaluate the predictive performance of the NORPACS score, and assess management outcomes of noreflow during primary PCI. Materials and methods: This analytical cross-sectional study consecutively enrolled all-comer patients with STEMI patients undergoing primary PCI at Ca Mau General Hospital between June 2025 and February 2026. Results: Mean age was 64.9 years, and 66.7% of the patients were male. The incidence of no-reflow was 13.6% (n = 31). The NORPACS score demonstrated excellent discriminative ability for predicting no-reflow, with an area under the receiver operating characteristic curve (AUC) of 0.902 (95% CI: 0.834-0.970, p < 0.001), cut off point = 7.5 (Youden index = 0.76). Following management, 77.4% of patients achieved angiographic restoration of coronary flow. Conclusions: The incidence of no-reflow after primary PCI in STEMI patients was 13.6% and was accurately predicted by the NORPACS score (AUC 0.902). However, management outcomes remain suboptimal, highlighting the need for improved preventive and therapeutic strategies.
Keywords
ST Elevation Myocardial Infarction, percutaneous coronary intervention, noreflow phenomenon, risk assessment, myocardial reperfusion
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