title: TIMI frame count and adverse events in women with no obstructive coronary disease: a pilot study from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE).
abstract: BACKGROUND
  TIMI frame count (TFC) predicts outcomes in patients with obstructive coronary artery disease (CAD); it remains unclear whether TFC predicts outcomes in patients without obstructive CAD.
  
  
  METHODS
  TFC was determined in a sample of women with no obstructive CAD enrolled in the Women's Ischemia Syndrome Evaluation (WISE) study. Because TFC is known to be higher in the left anterior descending artery (LAD), TFC determined in the LAD was divided by 1.7 to provide a corrected TFC (cTFC).
  
  
  RESULTS
  A total of 298 women, with angiograms suitable for TFC analysis and long-term (6-10 year) follow up data, were included in this sub-study. Their age was 55±11 years, most were white (86%), half had a history of smoking, and half had a history of hypertension. Higher resting cTFC was associated with a higher rate of hospitalization for angina (34% in women with a cTFC >35, 15% in women with a cTFC ≤35, P<0.001). cTFC provided independent prediction of hospitalization for angina after adjusting for many baseline characteristics. In this cohort, resting cTFC was not predictive of major events (myocardial infarction, heart failure, stroke, or all-cause death), cardiovascular events, all-cause mortality, or cardiovascular mortality.
  
  
  CONCLUSIONS
  In women with signs and symptoms of ischemia but no obstructive CAD, resting cTFC provides independent prediction of hospitalization for angina. Larger studies are required to determine if resting TFC is predictive of major events in patients without obstructive coronary artery disease.
authors.affiliation: Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: John W
authors.initials: JW
authors.lastname: Petersen
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: B Delia
authors.initials: BD
authors.lastname: Johnson
authors.affiliation: College of Nursing, University of South Florida, Tampa, Florida, United States of America.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.affiliation: Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: R David
authors.initials: RD
authors.lastname: Anderson
authors.affiliation: Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Handberg
authors.affiliation: Division of Cardiology, Brown University, Providence, Rhode Island, United States of America.
authors.forename: Barry
authors.initials: B
authors.lastname: Sharaf
authors.affiliation: Division of Cardiology, Barbra Streisand Women's Heart Center, Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
authors.forename: Puja K
authors.initials: PK
authors.lastname: Mehta
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Sheryl F
authors.initials: SF
authors.lastname: Kelsey
authors.affiliation: Division of Cardiology, Barbra Streisand Women's Heart Center, Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
authors.forename: C Noel Bairey
authors.initials: CN
authors.lastname: Merz
authors.affiliation: Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, United States of America.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Pepine
mesh_terms: D001158:Arteries / Q000503:physiopathology; D003327:Coronary Disease / Q000503:physiopathology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D054555:National Heart, Lung, and Blood Institute (U.S.); D010865:Pilot Projects; D014481:United States; D016387:Women's Health