Preprocedural TIMI flow grade 3 was an independent predictor of one-year survival in high-risk patients with acute myocardial infarction treated by primary angioplasty (p < 0.05).
Cohort (n=1,791)
No
Does preprocedural TIMI flow grade 3 improve one-year survival in patients with acute myocardial infarction treated by primary angioplasty?
Preprocedural TIMI flow grade 3 is an independent predictor of one-year survival in high-risk STEMI patients undergoing primary angioplasty, emphasizing the prognostic value of early recanalization.
p-value: p=<0.05
OBJECTIVES: The aim of the study was to evaluate the impact of preprocedural Thrombolysis In Myocardial Infarction (TIMI) flow on one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty. BACKGROUND: Although there is an excellent outcome conferred by primary angioplasty in patients with STEMI, the prognostic role of early recanalization in these patients has yet to be investigated. METHODS: Our population is composed of 1,791 patients with acute myocardial infarction treated by primary angioplasty at our institution from 1994 to 2001. All angiographic, clinical, and follow-up data were prospectively collected. According to the TIMI risk score, patients were stratified in low- and high-risk groups. RESULTS: Preprocedural TIMI flow was related to postprocedural TIMI flow grade 3 (p = 0.002), myocardial blush grade 2 to 3 (p < 0.001), enzymatic infarct size (p < 0.001), predischarge ejection fraction (p < 0.001), and one-year mortality (p < 0.05). Multivariate analysis showed that preprocedural TIMI flow grade 3 was an independent predictor of one-year survival in high-risk patients (p < 0.05). CONCLUSIONS: This study shows that preprocedural TIMI flow grade 3 is an independent predictor of one-year survival in high-risk patients with acute myocardial infarction treated by primary angioplasty. These data suggest that all efforts should be made to obtain early and optimal restoration of antegrade flow, particularly in high-risk patients and when transportation to tertiary centers, with a conceivable further time delay, is required.
Luca et al. (Thu,) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=1,791). Preprocedural TIMI flow grade 3 vs. Lower preprocedural TIMI flow grades was evaluated on One-year mortality (p=<0.05). Preprocedural TIMI flow grade 3 was an independent predictor of one-year survival in high-risk patients with acute myocardial infarction treated by primary angioplasty (p < 0.05).