title: The Open Artery Hypothesis: Past, Present, and Future.
abstract: The survival benefit following a reperfusion strategy, be it pharmacologic or mechanical, appears to be due to both full and early reperfusion. While the TIMI Flow Grade classification scheme has been a useful tool to assess coronary blood flow in acute syndromes, it has several limitations. A newer method of assessing coronary blood flow called the Corrected TIMI Frame Count method has the following advantages: (1) it is a continuous quantitative variable rather than a categorical qualitative variable; (2) the flow in the non-culprit artery is not assumed to be normal as it is in the assessment of TIMI Grade 3 Flow; (3) there is simplified reporting of reperfusion efficacy through the use of a single number instead of expressing the data in 2 to 4 categories; (4) because a single number rather than 4 categories is used to report the data, there is more efficient use of the dataset by increasing the statistical power; and finally (5) coronary flow can be expressed in intuitive terms (e.g. time or cm/sec for strategy A versus time or cm/sec for strategy B). This paper reviews the history of the open artery hypothesis and recent advances in the field.
authors.affiliation: Cardiovascular Division of the Department of Medicine, the West Roxbury Veteran's Administration & Brigham and Women's Hospitals, Harvard Medical School, Boston Massachusetts.
authors.forename: M
authors.initials: M
authors.lastname: Goel
authors.forename: J T
authors.initials: JT
authors.lastname: Dodge
authors.forename: M
authors.initials: M
authors.lastname: Rizzo
authors.forename: C
authors.initials: C
authors.lastname: McLean
authors.forename: K A
authors.initials: KA
authors.lastname: Ryan
authors.forename: W L
authors.initials: WL
authors.lastname: Daley
authors.forename: C P
authors.initials: CP
authors.lastname: Cannon
authors.forename: C M
authors.initials: CM
authors.lastname: Gibson