title: Relation of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grades to residual thrombus following the restoration of epicardial patency in ST-elevation myocardial infarction.
abstract: Clinical and angiographic data were analyzed from 929 patients who had ST-elevation myocardial infarction and open epicardial arteries after fibrinolytic therapy. Residual angiographically evident thrombus was associated with more frequent Thrombolysis In Myocardial Infarction (TIMI) grade 2 flow (33.6% vs 26.8%, p = 0.03), higher corrected TIMI frame counts (34 vs 31 frames, p = 0.0003), and lower TIMI myocardial perfusion grades (43.0% vs 32.0% TIMI myocardial perfusion grades 0/1, p = 0.001) among all patients and among patients who had TIMI grade 3 flow (33.5% vs 26.0% TIMI myocardial perfusion grades 0/1, p = 0.043). In multivariate analyses, angiographically evident thrombus was associated with higher corrected TIMI frame counts and worsened myocardial perfusion independent of clinical and angiographic covariates, including TIMI grade 3 flow.
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, and TIMI Study Group, Brigham & Women's Hospital, Harvard Medical School, Cambridge, MA, USA.
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.forename: Aaron
authors.initials: A
authors.lastname: Weisbord
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Karmpaliotis
authors.forename: Sabina A
authors.initials: SA
authors.lastname: Murphy
authors.forename: Robert P
authors.initials: RP
authors.lastname: Giugliano
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cannon
authors.forename: Elliott M
authors.initials: EM
authors.lastname: Antman
authors.forename: E Magnus
authors.initials: EM
authors.lastname: Ohman
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Roe
authors.forename: Eugene
authors.initials: E
authors.lastname: Braunwald
authors.forename: C Michael
authors.initials: CM
authors.lastname: Gibson
mesh_terms: D001783:Blood Flow Velocity; D017023:Coronary Angiography; D003326:Coronary Circulation; D006801:Humans; D007262:Infusions, Intravenous; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D010959:Tissue Plasminogen Activator