Author + information
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 TIMI flow. The primary outcome was the major adverse cardiac events (MACE), defined as a composite of cardiac death (CD), non-fatal myocardial infarction (MI) and target lesion revascularization (TLR).
Results and Conclusion
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 sub-groups in NSTEMI (aHR, 0.932; 95% CI 0.586 to 1.484, p = 0.087). In STEMI patients, good post-procedural 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 MACE. Meanwhile, post-procedural TIMI flow had no effect on long-term outcomes in NSTEMI patients.