Abstract 3163: Association of Pre-PCI TIMI flow grade (TFG) with Subsequent Mortality in Patients Presenting with ST-Elevation Myocardial Infarction (STEMI)
Background: Pre-procedural TIMI flow grade has been associated with mortality (both in-hospital and long-term) in patients (pts) undergoing percutaneous coronary intervention (PCI) following STEMI in randomized trials. This relationship has not been well characterized in a large heterogeneous real world population.
Methods: A cohort of 8,133 patients presenting with STEMI in the National Registry of Myocardial Infarction (NRMI) was studied. Analysis of the relationship between pre-PCI TFG and in-hospital mortality was performed.
Results: Of the 8133 patients, 6307 (77.5%) had TFG 0/1, 1178 (14.5%) had TFG 2, and 648 (8.0%) had TFG 3. Patients with TFG 0/1 before PCI (primary, rescue or facilitated) had an in-hospital mortality rate of 3.3% compared with TFG 2 of 1.6% and TFG 3 of 1.2% (P < 0.001). Pre-PCI TFG was associated with significant differences in mortality in all subgroups including age, gender, and location of infarct (see table⇓). Among pts with TFG 3 post PCI, mortality was still associated with pre-PCI TFG (pre-TFG 0/1 = 2.7%, pre-TFG 2 = 1.5%, TFG 3 = 1.2%, P = 0.002).
Conclusion: Pre-PCI TFG is associated with in-hospital mortality in a heterogeneous group of real world patients presenting with STEMI treated with PCI, including those with TFG 3 following PCI.