Predictors of delayed and no-reflow as recognized with Thrombolysis in Myocardial Infarction [TIMI] flow grade following Primary Percutaneous Coronary Angioplasty.
Background:Initial percutaneous coronary interference (PCI) is still connected by a noticeable incidence of suboptimal coronary flow thrombolysis in infarction of myocardial (TIMI). The predictors of slow and no-reflow in cases that supported initial PCI in our institute was searched for and the relationship of these parameters with major adverse cardiovascular effects (MACE) was assessed.Material and Method:397 patients with AMI displaying in 24 hours of the sign opening were retrospectively enrolled and underwent primary PCI between March 2006 and March 2012. Demographic, clinical, and procedural data were retrieved from our institutional databank. The baseline and post-PCI flow of blood in the revascularized artery was ranked based on the TIMI grading method. The follow-up visits were performed after one, six and twelve month from hospitalization. All the mortalities and complications were recorded within this period for evaluate the MACE.Results:The frequency of diabetes mellitus and renal failure were importantly larger in cases with a TIMI flow of 0-1 (p=0.03 & p=.01, respectively). Similarly, level of serum creatine were importantly larger in cases with a TIMI flow of 0-1. The predictors for TIMI flow included that utilize of Adenosin or Integrilin, diabetes mellitus, POIT, long tubular lesion, and injury at LAD territory. The incidence of MACE was significantly higher in patients with a TIMI flow of 0-1 (P=0.001) and the survival in this subgroup was significantly poorer (Hazard ratio=4.96; P<0.001).Conclusion:A low TIMI flow is accompanied by a poorer survival and a higher MACE and is influenced by some clinical and vascular characteristics.
Department of Cardiology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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M
Bahrehmand
Department of Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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E
Sadeghi
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Shafiee
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
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Y
Nozari
TIMI Flow; myocardial infarction; no reflow; subcutaneous Coronary interposition