Abstract 11068: Hyperemic Coronary Flow (TIMI-4) is Not Associated with Favorable Short-Term Outcome in Patients who Underwent Primary Percutaneous Coronary Intervention
Background: The short and long term prognostic importance of the final TIMI flow and corrected TIMI frame count (cTFC) in patients who underwent primary percutaneous coronary intervention (pPCI) is well known. Hyperemic coronary flow, also know as TIMI-4 flow, is defined as cTFC <14. However, there is no sufficient evidence for the short and long term prognostic importance of TIMI 4 flow in patients who underwent pPCI. In this study we aimed to investigate the impact of the TIMI 4 flow on short term outcome (30 days) in patients who underwent pPCI.
Methods: The study population consisted of 460 patients (54.7±11.2, male 83.9%) with acute myocardial infarction treated by pPCI. Infarct related artery was LAD in 56.2%, LCx in 14% and RCA in 28.6%. TIMI III flow was achieved in 80.9% of the patients, and the mean cTFC was 26.9±17.4.
Results: Final TIMI-4 flow rate was 7.4% in the study population. In univariate analysis, there were no significant differences between the patients with TIMI-4 flow and TIMI<=III for pain-balloon, door-balloon, age, RLA, lesion length, number of balloon pre-dilation, an clopidogrel usage. However, the infarct related artery was more frequently LAD in patients with TIMI-4 flow compared to patients with TIMI<=III(11% vs 3.5%, p=0.001).The 30 day mortality was 0% in patients with TIMI-4 flow whereas it was 7.7% in patients with TIMI90 min) and door- balloon times (>30 dk), >65 age, and killip>=II and TIMI30 dk), >65 age and Killip>=II were independent predictors of 30 day mortality.
Conclusions: In patients with STEMI, treated with primary percutaneous coronary intervention, post-procedural hyperemic TIMI-4 flow is not associated with 30-day mortality.
- © 2011 by American Heart Association, Inc.