Your browser doesn't support javascript.
loading
Prognostic impact of pre-interventional culprit artery thrombolysis in myocardial infarction (TIMI) flow in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention.
Shaaban, Raouf; El Etriby, Adel; Kamal, Diaa; Mostafa, Ahmad E.
Afiliação
  • Shaaban R; Cardiology Department, Ain Shams University, 38 Ramsis Street, El Abbaseya, Cairo, Egypt. raoufmahmoud88@gmail.com.
  • El Etriby A; Cardiology Department, Ain Shams University, 38 Ramsis Street, El Abbaseya, Cairo, Egypt.
  • Kamal D; Cardiology Department, Ain Shams University, 38 Ramsis Street, El Abbaseya, Cairo, Egypt.
  • Mostafa AE; Cardiology Department, Ain Shams University, 38 Ramsis Street, El Abbaseya, Cairo, Egypt.
Egypt Heart J ; 74(1): 52, 2022 Jun 27.
Article em En | MEDLINE | ID: mdl-35759059
ABSTRACT

BACKGROUND:

Primary percutaneous coronary intervention (PCI) is considered the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). However, the prognostic role of spontaneous re-canalization in STEMI patients is still not clear. The purpose of this study is to evaluate the impact of pre-procedural TIMI flow grade in the culprit coronary artery on the short and long term prognosis in Egyptian patients presented with STEMI and treated with primary PCI.

RESULTS:

A dual center, prospective observational study that was conducted in the period from January 2019 till June 2020 and enrolled 150 STEMI patients presented within 24 h from onset of chest pain. Initial angiography was done with analysis of TIMI flow grade in the infarct related artery. Of the 150 enrolled patients; 93 patients (62%) were found to have initial TIMI flow grade 0 (group A) and 57 patients (38%) had initial TIMI flow grade I-III (group B). There was a strong association between cardiac mortality and pre-procedural TIMI flow grade. 12 mortalities (8% of total study population) were recorded during our study period; in-hospital mortality was reported in 7 patients in group A, yet no mortalities were recorded in-hospital in group B (P value = 0.033). At 1 year follow up; 5 mortalities were recorded in group A with no mortalities at all in group B (P value = 0.005). There was a trend towards an increase in acute heart failure incidence in group A yet no statistically significant value was achieved (P value = 0.112). Target lesion revascularization was reported in 8 patients in group A and in only 3 patients in group B (P value 0.446).

CONCLUSIONS:

Despite the evolution in primary PCI strategies and the continuous advancement in anti-thrombotic treatment; pre-interventional infarct related artery TIMI flow grade I-III is associated with better in hospital and 1 year outcome, specifically significantly lower cardiac mortality compared to patients who had TIMI flow grade 0 at initial angiography.
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies Idioma: En Ano de publicação: 2022 Tipo de documento: Article