Abstract: Objective To identify independent no-reflow predictors during primary percutaneous coronary intervention(PPCI) in female patients with ST-segment elevation acute myocardial infarction(STEMI) after various contemporary interventional strategies, thus to establish a model for predicting no-reflow status. Methods Totally 320 female patients with STEMI successfully treated with PPCI were divided into no-reflow group and normal reflow group. Results The no-reflow status was found in 81(25.3%) of 320 female patients. Univariate and multivariate logistic regression identified that low systolic blood pressure(SBP) on admission(<100 mm Hg, OR=1.991, 95% CI: 1.018~3.896; P=0.004), target lesion length(>20 mm, OR=1.948, 95% CI: 1.908~1.990; P=0.016), collateral circulation(0-1, OR=1.952, 95% CI: 1.914~1.992; P=0.019), pre-PPCI thrombus score(≥4, OR=4.184, 95% CI: 1.482~11.813; P=0.007), and intra-aortic balloon pulsation(IABP) use before PPCI(OR=1.949, 95% CI: 1.168~3.253; P=0.011) were independent no-reflow predictors. The no-reflow incidence rate significantly increased as the numbers of independent predictors increased[0%(0/2), 10.8%(9/84), 14.5%(17/117), 37.7%(29/77), 56.7%(17/30), and 81.8%(9/11) in female patients with 0, 1, 2, 3, 4, and 5 independent predictors, respectively; P=0.000]. Conclusion The 5 no-reflow predictor variables were low SBP on admission <100 mm Hg, target lesion length >20 mm, collateral circulation 0-1, pre-PPCI thrombus score ≥4, and IABP use before PPCI in female patients with STEMI and PPCI. The prediction model provides a basis for therapeutic decision making.

Key words: female, acute myocardial infarction, percutaneous coronary intervention, no-reflow