Key result
Antiplatelet drug use on admission was independently associated with a higher likelihood of pre-procedural TIMI flow grade 3 (OR 1.492), which was related to lower in-hospital mortality.
Why the study?
Does pre-procedural TIMI flow grade 3 improve in-hospital outcomes in patients with STEMI, and what factors are associated with it?
Observational (n=2,182)
Yes
Does pre-procedural TIMI flow grade 3 improve in-hospital outcomes in patients with STEMI, and what factors are associated with it?
In patients with STEMI, pre-procedural TIMI flow grade 3 is associated with improved in-hospital outcomes and is independently predicted by prior antiplatelet drug use.
Answers are grounded in this paper and cite their sources.
Antiplatelet use on admission was associated with pre-procedural TIMI 3 flow in STEMI; leaves open whether early therapy improves outcomes.
It has been shown that the patency of an infarct-related artery (IRA) before primary percutaneous coronary intervention determines post-procedural success, better preservation of left ventricular function, and lower in-hospital mortality. However, the factors associated with pre-procedural Thrombolysis In Myocardial Infarction (TIMI) flow have not been fully investigated.The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective multicenter registry conducted at 28 Japanese medical institutions between July 2012 and March 2014. We enrolled 3,283 consecutive patients with acute myocardial infarction who were admitted to a participating institution within 48 hours of symptom onset. There were 2,262 patients (68.9%) with ST-elevation myocardial infarction (STEMI), among whom 2,182 patients underwent emergent or urgent coronary angiography.Pre-procedural TIMI flow grade 3 was related to post-procedural TIMI flow grade 3 (P < 0.001), lower enzymatic infarct size (P < 0.001), lower ventricular tachycardia and ventricular fibrillation (P = 0.049), and lower in-hospital mortality (P = 0.020). A history of antiplatelet drug use was associated with pre-procedural TIMI flow.Antiplatelet drug use on admission was associated with pre-procedural TIMI flow. The patency of the IRA in patients with STEMI was related to procedural success and decreased enzymatic infarct size, fatal arrhythmic events, and in-hospital mortality.
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Hashimoto et al. (2018) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=2,182). Antiplatelet drug use on admission vs. No antiplatelet drug use on admission was evaluated on Pre-procedural TIMI flow grade 3 (OR 1.492, 95% CI 1.100-2.008, p=0.010). Antiplatelet drug use on admission was independently associated with a higher likelihood of pre-procedural TIMI flow grade 3 (OR 1.492), which was related to lower in-hospital mortality.
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