Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2003 Nov 19;42(10):1739-46.
doi: 10.1016/j.jacc.2003.07.012.

Clinical and angiographic correlates and outcomes of suboptimal coronary flow inpatients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Rajendra H Mehta  1 , Kishore J Harjai, David Cox, Gregg W Stone, Bruce Brodie, Judy Boura, William O'Neill, Cindy L Grines; Primary Angioplasty in Myocardial Infarction (PAMI) Investigators
Affiliations
Free article

Clinical and angiographic correlates and outcomes of suboptimal coronary flow inpatients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Rajendra H Mehta et al. J Am Coll Cardiol. .
Free article

Abstract

Objectives: The purpose of this study was to determine the clinical and angiographic correlates and outcomes of patients with suboptimal coronary flow after primary percutaneous coronary interventions (PCI).

Background: The clinical and angiographic correlates and outcomes of Thrombolysis in Myocardial Infarction (TIMI) < or =2 flow in patients treated with primary PCI are not known.

Methods: We evaluated 3,362 patients with ST elevation myocardial infarction enrolled in various Primary Angioplasty in Myocardial Infarction trials, who underwent primary PCI.

Results: Post-procedural final TIMI < or =2 flow occurred in 232 (6.9%) patients. Multivariate analysis identified age > or =70 years (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1 to 2.2), diabetes (OR 1.9; 95% CI, 1.3 to 2.7), symptom onset to emergency room presentation (OR 1.1; 95% CI, 1.1 to 1.2); initial TIMI < or =1 flow (OR 3.2; 95% CI, 1.9 to 5.5), and left ventricular ejection fraction <50% (OR 1.7; 95% CI, 1.2 to 2.4) as independent correlates of final TIMI < or =2 flow. In-hospital (composite of reinfarction, ischemic target vessel revascularization, or death, as well as these events individually) and one-year (reinfarction and/or death) events occurred more frequently in patients with TIMI < or =2 flow. The Cox proportional hazards model identified TIMI < or =2 flow to be independently associated with one-year mortality (hazard ratio 3.8, 95% CI, 2.5 to 5.7).

Conclusions: Final TIMI < or =2 flow, although uncommon after primary PCI, was strongly associated with hospital and one-year adverse events. The clustering of final TIMI < or =2 flow in high-risk groups may partially explain the poor prognosis of these patients. Awareness of these risk factors may be useful to clinicians to triage and treat patients undergoing primary PCI.

PubMed Disclaimer