Relation of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grades to residual thrombus following the restoration of epicardial patency in ST-elevation myocardial infarction.
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.
Kirtane
Ajay J
AJ
Department of Medicine, Beth Israel Deaconess Medical Center, and TIMI Study Group, Brigham & Women's Hospital, Harvard Medical School, Cambridge, MA, USA.
Weisbord
Aaron
A
Karmpaliotis
Dimitrios
D
Murphy
Sabina A
SA
Giugliano
Robert P
RP
Cannon
Christopher P
CP
Antman
Elliott M
EM
Ohman
E Magnus
EM
Roe
Matthew T
MT
Braunwald
Eugene
E
Gibson
C Michael
CM
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*
D010959:Tissue Plasminogen Activator