Coronary cyclic flow variations following primary angioplasty is associated with poor short-term prognosis.
OBJECTIVE
Recent studies have shown that coronary cyclic flow variations (CCFV) is a platelet-related phenomenon that occurred following reperfusion. Although CCFV predicts acute complications following thrombolytic therapy, its impact following percutaneous coronary interventions (PCI) has not been evaluated yet.


RESULTS
One hundred and thirty-one patients with ST-segment Elevation Myocardial Infarction (STEMI) who underwent PCI were included in the analysis. All patients have 24-hour ST-segment monitoring. The development of CCFV was defined as > or = 3 ST-segment transitions (> or =150 microV). We divided the population in two groups according to the presence (n=14, 10.6%) or absence (n=117) of CCFV. The relation between CCFV and 30-day major adverse cardiac events (MACE) was analyzed using a multivariate logistic regression model adjusting for age, sex, diabetes, smoking, anterior infarct, Killip class, and final TIMI flow grade. Clinical and angiographic characteristics were similar between the two groups. Higher 30-day mortality (21.4 vs. 3.8%, p=0.022) and MACE rates (42.9 vs. 10.7%, p=0.005) were seen in the CCFV group. Multivariate regression analysis revealed that patients with CCFV were at increased risk of 30-day MACE (adjusted RR 5.09; 95% CI 1.3-19.1; p=0.0016).


CONCLUSIONS
The presence of CCFV altered primary PCI may provide an early indication of insufficient myocardial perfusion and impending catastrophic outcome.
Albertal
Mariano
M
Department of Interventional Cardiology and Endovascular Therapeutics, Instituto Cardiovascular de Buenos Aires, Buenos Aires, Argentina. malbertal@fibertel.com.ar
Cura
Fernando
F
Krucoff
Mitchell W
MW
Baeza
Ricardo
R
Garcia Escudero
Alejandro
A
Padilla
Lucio T
LT
Thierer
Jorge
J
Fieg
Sebastian
S
Trivi
Marcelo
M
Belardi
Jorge A
JA
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods / Q000401:mortality*; D001783:Blood Flow Velocity / Q000502:physiology; D003326:Coronary Circulation / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015425:Myocardial Reperfusion / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome