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

来源：

INTERNATIONAL HEART JOURNAL | 2017年 / 58卷 / 05期

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

页码：674 / 685

页数：12

共 41 条

[31] ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines) - Executive summary - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) - Endorsed by the Society for Cardiac Angiography and Interventions [J].