The Association of Plasma Osmolarity with No-Reflow in Patients with ST Elevation Myocardial Infarction: A Retrospective Cohort Study

Background: In this study, we sought to examine the statistical association of plasma osmolarity with noreflow development in patients with ST-segment elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (pPCI).

Methods: In this retrospective study, we included data from 1294 consecutive STEMI patients who have undergone pPCI. For each patient, we measured the plasma osmolarity using the following equation: 2 × sodium+0.9 glucose+0.93 × urea × 0.5.

Results: Occurrence of angiographic no-reflow was 21.7% (n=281) in the study. The mean plasma osmolarity level was significantly higher in patients with no-reflow compared to those without no-reflow (300.6 ± 9.4 mOsmol/L versus 292.8 ± 10.5 mOsmol/L, P < .001, respectively). In multivariate logistic regression analysis, plasma osmolarity was found to be independently related to no-reflow development (odds ratio: 1.061; 95% CI, 1.045-1.076; P < .001). According to the receiver operating characteristic curve analysis, a plasma osmolarity level greater than 290.2 mOsmol/L was identified as the optimal value for predicting the occurrence of no-reflow. This cutof demonstrated a sensitivity of 91.8% and a specificity of 45.8%.

Conclusion: This is the first study to establish an independent relationship between higher plasma osmolarity and the development of no-reflow in patients with STEMI who have undergone pPCI. This finding suggests that plasma osmolarity may be a useful marker for the prediction of no-reflow in STEMI patients who have undergone pPCI.

Cite this article as: Hamideyin Ş, Artaç İ. The association of plasma osmolarity with no-reflow in patients with st elevation myocardial infarction: A retrospective cohort study. Eurasian J Med., 2024;56(1):27-34.