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Clinical and Angiographic Predictors of Suboptimal Coronary Flow After Primary Percutaneous Coronary Intervention in Patients With St-Elevation Myocardial Infarction Publisher



Soleimani A1 ; Nayebi S2 ; Ashraf H3 ; Naseri AS1 ; Oraii A2 ; Kazemian S2 ; Tayeb R1 ; Majidi F4 ; Fatahi M2 ; Nateghi S5 ; Karbalai Saleh S1
Authors
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Authors Affiliations
  1. 1. Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. School of Medicine, Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran

Source: ARYA Atherosclerosis Published:2023


Abstract

INTRODUCTION: This study aimed to investigate the clinical and angiographic characteristics of patients with ST-elevation myocardial infarction who experienced primary percutaneous coronary intervention failure. METHOD: This retrospective observational study was derived from the Primary Angioplasty Registry of Sina Hospital (PARS). A total of 548 consecutive patients with ST-elevation myocardial infarction who underwent primary percutaneous coronary intervention between November 2016 and January 2019 were evaluated. Percutaneous coronary intervention failure was defined as Thrombolysis in Myocardial Infarction (TIMI) flow ≤ 2 or corrected TIMI frame count (cTFC) ≥ 28. RESULTS: The study population consisted of 458 (83.6%) males and 90 (16.4%) females with a mean age of 59.2 ± 12.49 years. TIMI flow 3 was achieved in 499 (91.1%) patients after the procedure, while 49 (8.9%) patients developed TIMI ≤ 2. The findings showed that cTFC ≥ 28 was present in 50 (9.1%) patients, while 489 (89.2%) patients had cTFC < 28. Multiple regression analysis shows that age 1.04 (1.01, 1.07), duration of pain onset to first medical contact time 1.04 (1.00, 1.18), and left anterior descending artery involvement 3.15 (1.21, 8.11) were independent predictors of TIMI ≤ 2. CONCLUSION: Even though TIMI ≤ 2 was uncommon among the study population, it was associated with adverse in-hospital outcomes. The results indicate that earlier emergency medical service arrival and shorter transfer time to the referral center can dramatically reduce the primary percutaneous coronary intervention failure rate. © 2023, Isfahan University of Medical Sciences(IUMS). All rights reserved.
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