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• W185815770 abstract "Background TIMI myocardial perfusion grade (TMPG) reflects the integrity of microvasculature in ST-elevation myocardial infarction (STEMI). We sought to investigate whether TMPG evolution during primary angioplasty (pPCI) in spontaneously reperfused STEMI patients might predict long-term outcomes. Methods 392 patients with TIMI-3 flow before pPCI were analyzed. According to pre- and post-pPCI TMPG four reperfusion patterns were created: A. TMPG deterioration from grade 2/3 to 0/1 after pPCI (n=55, 14.0%), B. TMPG-0/1 before and after pPCI (n=111, 28.3%), C. TMPG improvement from grade 0/1 to 2/3 (n=52, 13.3%), D. TMPG-2/3 before and after pPCI (n=174, 44.4%). 30-day and 1-year mortality and heart failure requiring hospitalization (HF-hosp) were recorded. Left ventricular ejection fraction (LVEF) was measured at first day (1D) and after 6 months (6M). Results 1D-LVEF was similar in A–D groups. After 6M, LVEF improved in pattern D (7.5±5.4%, p<0.01) and C (3.7±3.4%, p<0.05), deteriorated in pattern A (5.2±3.9%, p<0.01) and did not change in pattern B. 6M-LVEF increased (p<0.001) and frequency of 1-year HF-hosp decreased (p<0.001) in stepwise fashion among A–D patterns. A 30-day mortality rate for A–D patterns was 9.1%, 2.7%, 1.9% and 0%, respectively (p<0.001). 1-year mortality was 16.3%, 7.2%, 5.8% and 0.6%, respectively (p<0.001). By multivariate analysis (c-index=0.79), TMPG evolution was independent predictor of 1-year mortality (HR=2.5, 95%CI 1.3–4.0, p=0.006). Conclusions Maintaining TMPG-2/3 or improving TMPG-0/1 through pPCI in STEMI implies LV function recovery and good long-term survival. In contrast, substantial deterioration of TMPG is associated with lack of LV function recovery, and the highest mortality rate." @default.
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• W185815770 date "2011-02-01" @default.
• W185815770 modified "2023-09-27" @default.
• W185815770 title "Evolution of myocardial perfusion during primary angioplasty in spontaneously reperfused infarct-related artery" @default.
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• W185815770 doi "https://doi.org/10.1016/j.ijcard.2009.07.032" @default.
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