• Sevket Balta, Turgay Celik, Cengiz Ozturk, M Gungor Kaya, Mustafa Aparci, A Osman Yildirim, Mustafa Demir, Selim Kilic, İbrahim Aydin, and Atila Iyisoy.
• Gulhane Military Medical Academy, School of Medicine, Dept. of Cardiology, Etlik, Ankara, Turkey. Electronic address: drsevketb@gmail.com.
• Am J Emerg Med. 2016 Aug 1; 34 (8): 1542-7.

BackgroundNo-reflow phenomenon is a prognostic value in ST-segment elevation myocardial infarction (STEMI). Monocyte to high density lipoprotein ratio (MHR) has recently emerged as a marker of inflammation and oxidative stress in the cardiovascular disease.PurposeIn this study, we aimed to investigate the relation between MHR and no-reflow phenomenon in patients with STEMI undergoing primary percutaneous coronary intervention (pPCI).Material And MethodsA total of 600 patients with STEMI (470 men; mean age, 62 ± 12 years) admitted within 12 hours from symptom onset were included into this study. Patients were classified into 2 groups based on postintervention Thrombolysis in Myocardial Infarction (TIMI) flow grade: no-reflow-TIMI flow grade 0, 1, or 2 (group 1); angiographic success-TIMI flow grade 3 (group 2).ResultsAccording to admission whole-blood cell count results, the patients in the no-reflow group had significantly higher monocyte count and MHR values when compared with those of the reflow patients. After multivariate backward logistic regression, MHR remained independent predictors of no reflow after pPCI. Adjusted odds ratios were calculated as 1.09 for MHR (P< .001; confidence interval [CI], 1.07-1.12). Receiver operating characteristic curve analysis suggested that the optimum MHR level cutoff point for patients with no-reflow was 22.5, with a sensitivity and specificity of 70.2% and 73.3%, respectively (area under curve, 0.768; 95% CI, 0.725-0.811).ConclusionIn conclusion, MHR levels are one of the independent predictors of no reflow in patients with STEMI after pPCI.Copyright © 2016 Elsevier Inc. All rights reserved.

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