title: Relationship between corrected TIMI frame counts at three weeks and late survival after myocardial infarction.
abstract: OBJECTIVE
  To evaluate the corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (CTFC) as a predictor of late survival after myocardial infarction.
  
  
  BACKGROUND
  Thrombolysis in Myocardial Infarction flow grades predict late survival after myocardial infarction. The CTFC provides a more reproducible measurement of infarct-related artery blood flow than the TIMI flow grade, and has been linked to 30-day outcomes, but it has not yet been established how the CTFC correlates with late survival.
  
  
  METHODS
  Of 1,001 patients with acute myocardial infarction presenting within 4 h of symptom onset, 882 underwent angiography at approximately three weeks. Infarct artery flow was assessed, blinded to clinical outcomes, according to the CTFC and TIMI flow grade. Late cardiac mortality and survival were determined in 97.5% of patients.
  
  
  RESULTS
  The mean CTFC was 40 +/- 29 in 644 patent infarct arteries (median, 34 [interquartile range, 24 to 47]). The CTFC, assessed as a continuous univariate variable, was found to be a predictor of five-year survival, as was the TIMI flow grade (both p < 0.001). On multivariate analysis, factors associated with five-year survival included the ejection fraction or end-systolic volume index (both p < 0.001); exercise duration (p = 0.005), age (p = 0.008), diabetes (p = 0.02) and CTFC (p = 0.02) or TIMI flow (p = 0.02). The same factors, except for the CTFC and TIMI flow grade, were predictors of 10-year survival.
  
  
  CONCLUSIONS
  The CTFC three weeks after myocardial infarction was an independent predictor of five-year survival, but not 10-year survival. Although the CTFC provided additional prognostic information within TIMI flow grades, its superiority was not demonstrated.
authors.affiliation: Cardiology Department, Green Lane Hospital, Auckland, New Zealand. johnf@ahsl.co.nz
authors.forename: J K
authors.initials: JK
authors.lastname: French
authors.forename: T A
authors.initials: TA
authors.lastname: Hyde
authors.forename: I T
authors.initials: IT
authors.lastname: Straznicky
authors.forename: J
authors.initials: J
authors.lastname: Andrews
authors.forename: M
authors.initials: M
authors.lastname: Lund
authors.forename: D J
authors.initials: DJ
authors.lastname: Amos
authors.forename: A
authors.initials: A
authors.lastname: Zambanini
authors.forename: C J
authors.initials: CJ
authors.lastname: Ellis
authors.forename: B J
authors.initials: BJ
authors.lastname: Webber
authors.forename: S C
authors.initials: SC
authors.lastname: McLaughlin
authors.forename: R M
authors.initials: RM
authors.lastname: Whitlock
authors.forename: S O
authors.initials: SO
authors.lastname: Manda
authors.forename: H
authors.initials: H
authors.lastname: Patel
authors.forename: H D
authors.initials: HD
authors.lastname: White
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D017023:Coronary Angiography / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D016032:Randomized Controlled Trials as Topic; D013300:Streptokinase / Q000008:administration & dosage; D015996:Survival Rate; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D013300:Streptokinase; D010959:Tissue Plasminogen Activator