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01-01-2010 | Original Paper

Prognostic value of minimal blood flow restoration in patients with acute myocardial infarction after reperfusion therapy

Authors: Gjin Ndrepepa, Dritan Keta, Stefanie Schulz, Robert A. Byrne, Julinda Mehilli, Jürgen Pache, Melchior Seyfarth, Albert Schömig, Adnan Kastrati

Published in: Clinical Research in Cardiology | Issue 1/2010

Abstract

Purpose

The prognostic impact of low-flow reperfusion after percutaneous coronary intervention (PCI) in patients with ST-segment elevation acute myocardial infarction (STEMI) is unknown. The aim of the study was to investigate the impact of low-flow reperfusion after PCI in patients with STEMI.

Methods

This study included 1,761 patients with STEMI with a baseline thrombolysis in myocardial infarction (TIMI) flow grade 0 and no collateral circulation to the infarcted region before primary PCI. The primary outcome was 1-year mortality.

Results

At the end of PCI procedure there were 115 patients with post-PCI TIMI flow grade 0; 57 patients with TIMI flow grade 1; 218 patients with TIMI flow grade 2; and 1,371 patients with TIMI flow grade 3. At 1 year there were 36 deaths in patients with TIMI grade 0; 28 deaths in patients with TIMI grade 1; 42 deaths in patients with TIMI grade 2; and 162 deaths in patients with TIMI grade 3 [estimates of mortality 32.6, 49.1, 19.6 and 12.1%, respectively; odds ratio (OR) = 1.76, 95% CI 1.08–2.86, P = 0.02, for TIMI flow grade 1 vs. TIMI flow grade 0]. The Cox proportional hazards model identified post-PCI TIMI flow grade as an independent predictor of 1-year mortality [hazard ratio (HR) = 1.99, 95% CI 1.17–3.28; P = 0.01 for TIMI flow grade 1 vs. TIMI flow grade 0].

Conclusions

Patients with STEMI with totally occluded infarct-related arteries and no collateral blood flow to the infarcted region show a greater mortality with post-PCI TIMI flow grade 1 than TIMI flow grade 0.

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Title: Prognostic value of minimal blood flow restoration in patients with acute myocardial infarction after reperfusion therapy
Authors: Gjin Ndrepepa
Dritan Keta
Stefanie Schulz
Robert A. Byrne
Julinda Mehilli
Jürgen Pache
Melchior Seyfarth
Albert Schömig
Adnan Kastrati
Publication date: 01-01-2010
Publisher: D. Steinkopff-Verlag
Published in: Clinical Research in Cardiology / Issue 1/2010
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-009-0070-9

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Prognostic value of minimal blood flow restoration in patients with acute myocardial infarction after reperfusion therapy

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Purpose

Methods

Results

Conclusions

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