Key result
Lower pre-PCI TIMI grade, higher troponin, and lower systolic blood pressure were associated with suboptimal TIMI flow after primary PCI for anterior STEMI.
Why the study?
TIMI flow grade is an important predictor of outcomes in STEMI, but potential variables associated with suboptimal TIMI flow after PCI in anterior wall STEMI needed evaluation.
What are the risk factors for suboptimal TIMI flow after primary PCI in patients with anterior wall STEMI?
Cohort (n=107)
No
What are the risk factors for suboptimal TIMI flow after primary PCI in patients with anterior wall STEMI?
Answers are grounded in this paper and cite their sources.
Lower pre-PCI TIMI flow, higher periprocedural troponin levels, and lower minimal systolic blood pressure are predictors of suboptimal coronary blood flow following primary PCI in anterior STEMI.
Background and aims: Primary percutaneous coronary intervention (PCI) is regarded as the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). Thrombolysis in Myocardial Infarction (TIMI) flow grade has been an important and cohesive predictor of outcomes in STEMI patients. We sought to evaluate potential variables associated with the risk of suboptimal TIMI flow after PCI in patients with anterior wall STEMI. Methods: We evaluated 107 patients admitted to our hospital between 1 January 2019 and 31 December 2021 with a diagnosis of anterior wall STEMI treated with primary PCI. Results: Suboptimal TIMI flow grade (≤2) after PCI occurred in 14 (13%) patients while grade 3 was found in 93 (87%) of them presenting with anterior wall STEMI. Failure to achieve optimal TIMI 3 flow grade after PCI was associated with lower TIMI grade prior to PCI (OR 0.5477, 95% CI 0.2589–0.9324, p = 0.02), greater troponin concentration before (OR 1.0001, 95% CI 1–1.0001, p = 0.0028) and after PCI (OR 1.0001, 95% CI 1–1.0001, p = 0.0452) as well as lower mean minimal systolic blood pressure (OR 0.9653, 95% CI 0.9271–0.9985, p = 0.04). Conclusions: Among predictors of suboptimal TIMI flow grade after PCI, we noted lower TIMI grade flow pre-PCI, greater serum troponin concentrations in the periprocedural period and lower mean minimal systolic blood pressure.
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Maruszak et al. (2023) conducted a cohort in Anterior wall STEMI (n=107). Pre-PCI TIMI grade was evaluated on Suboptimal TIMI flow grade (≤2) after PCI (OR 0.5477, 95% CI 0.2589-0.9324, p=0.02). Lower pre-PCI TIMI grade, higher troponin, and lower systolic blood pressure were associated with suboptimal TIMI flow after primary PCI for anterior STEMI.
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