title: Myocardial perfusion grade predicts final infarct size and left ventricular function in patients with ST-elevation myocardial infarction treated with a pharmaco-invasive strategy (thrombolysis and early angioplasty).
abstract: OBJECTIVE
  Primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) usually restores TIMI 3 flow in the occluded artery, but microvascular impairment may persist in >30% of patients. Less is known about microvascular reperfusion in STEMI patients treated with thrombolysis followed by early PCI. We aimed to assess the association between TIMI myocardial perfusion (TMP) at the end of the PCI procedure and left ventricular function (LVEF) and infarct size after three months in such patients.
  
  
  RESULTS
  Patients with STEMI treated with thrombolysis and early PCI were included. TMP grade was assessed at the end of the PCI procedure, and MRI was performed after three months. Of the 89 patients included, 92% (n=82) had TIMI 3 flow at the end of the PCI procedure, while only 62% (n=55) had TMP grade 2 or 3. Patients with TMP grade 2-3 had significantly higher LVEF (59% [53-67] vs. 50% [41-56], p<0.0001) and smaller infarct size (8.3 ml [2.7-15.5] vs. 20.7 ml [13.0-36.0], p<0,0001) after three months.
  
  
  CONCLUSIONS
  In STEMI patients treated with thrombolysis and early PCI, the TMP grade at the end of the PCI procedure was significantly associated with LVEF and infarct size after three months.
authors: Department of Radiology and Nuclear Medicine, Division of Diagnostics and Intervention, Oslo University Hospital, Ullevål, Norway.
authors: Anne
authors: A
authors: Bethke
authors: Sigrun
authors: S
authors: Halvorsen
authors: Ellen
authors: E
authors: Bøhmer
authors: Michael
authors: M
authors: Abdelnoor
authors: Harald
authors: H
authors: Arnesen
authors: Pavel
authors: P
authors: Hoffmann
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D061345:Early Medical Intervention; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology*; D062645:Percutaneous Coronary Intervention; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*