Impact of Postprocedural TIMI Flow on Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction

被引:26
作者
Kim, Dae-Won [1 ]
Her, Sung-Ho [1 ]
Park, Mahn-Won [1 ]
Cho, Jung Sun [1 ]
Kim, Tae-Seok [1 ]
Kang, Hyeonjeong [1 ]
Sim, Doo Sun [2 ]
Hong, Young Joon [2 ]
Kim, Ju Han [2 ]
Ahn, Youngkeun [2 ]
Chang, Kiyuk [3 ]
Chung, Wook-Sung [3 ]
Seung, Ki-Bae [3 ]
Jeong, Myung-Ho [2 ]
Rho, Tai-Ho [4 ]
机构
[1] Catholic Univ Korea, Coll Med, Daejeon St Marys Hosp, Div Cardiol, 64 Daeheung Ro, Daejeon 34943, South Korea
[2] Chonnam Natl Univ, Chonnam Natl Univ Hosp, Cardiovasc Ctr, Gwangju, South Korea
[3] Catholic Univ Korea, Div Cardiol, Seoul St Marys Hosp, Coll Med, Seoul, South Korea
[4] Catholic Univ Korea, Div Cardiol, Seoul St Pauls Hosp, Coll Med, Seoul, South Korea
关键词
STEMI; NSTEMI; MACE; ST-SEGMENT ELEVATION; PERCUTANEOUS CORONARY INTERVENTION; TISSUE-PLASMINOGEN-ACTIVATOR; NO-REFLOW PHENOMENON; BLOOD-FLOW; INTRAVENOUS STREPTOKINASE; PRIMARY ANGIOPLASTY; INVASIVE STRATEGY; UNSTABLE ANGINA; FOLLOW-UP;
D O I
10.1536/ihj.16-448
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This study aimed to evaluate the clinical prognostic implications of postprocedural Thrombolysis in Myocardial Infarction (TIMI) flow in acute myocardial infarction patients. A total of 2796 ST-elevation myocardial infarction (STEMI) and 1720 non ST-elevation myocardial infarction (NSTEMI) patients treated in 8 hospitals affiliated with the Catholic University of Korea and Chonnam National University Hospital were analyzed. The study populations were divided according to the final TTMI flow. The primary outcome were the major adverse cardiac events (MACE), defined as a composite of cardiac deaths (CD), nonfatal myocardial infarctions (MI), and target lesion revascularization (TLR). Over a median follow-up of 3.3 years (minimum 2 to maximum 5 years), MACE and CD occurred more frequently in STEMI patients with TIMI <= 2 group than those with TIMI 3 (MACE: adjusted hazard ratio [aHR], 1.962; 95% confidence interval [CI] 1.513 to 2.546, P< 0.001, CD: aHR, 3.154, CI 2.308 to 4.309, P< 0.001). However, there was no significant difference between the two subgroups in NSTEMI (aHR, 0.932; 95% CI 0.586 to 1.484, P = 0.087). In STEMI patients, good postprocedural TIMI flow after PCI was associated with favorable clinical outcomes. And the effect of poor TIMI flow in STEMI was on death, not the components of long-term outcomes in NSTEMI patients.
引用
收藏
页码:674 / 685
页数:12
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