Combination of electrocardiographic and angiographic markers of reperfusion in the prediction of infarct size in patients with ST-segment elevation myocardial infarction undergoing successful primary angioplasty

TIMI myocardial perfusion frame count: A new method to assess myocardial perfusion and its predictive value for short‐term prognosis

“…Both methods have proven useful for the sensitive assessment of microvascular flow and prediction of clinical outcomes after myocardial infarction. However, they are limited by their subjective and categorical natures [12][13][14][15][16][17]. Recently, a computer-assisted procedure based on MBG was developed to objectively quantify myocardial perfusion, and has proven to accurately estimate follow-up ejection fraction and left ventricular remodeling in patients with STEMI [23].…”

“…However, epicardial blood flow does not necessarily equate to myocardial perfusion; not every patient with TIMI 3 flow after successful PCI achieves effective myocardial perfusion. Although epicardial TIMI 3 flow could be restored in the infarct-related artery (IRA) in >90% of patients undergoing primary PCI, normalization of myocardial perfusion was achieved less frequently, with detrimental impacts on survival [12][13][14][15][16][17].…”

Trombectomia adjunta em intervenção percutânea primária para infarto agudo do miocárdio

“…Selected RCTs of adjunctive thrombectomy have used MCE 3,9 , Tc-99m sestamibi gated single photon emission computed tomography (SPECT) [10][11][12][13][14] and late gadolinium enhancement by CMR 4 . Yet, most RCTs have relied on validated angiographic or electrocardiographic surrogate markers or myocardial perfusion 15 . De Luca et al 15 reported that TMPG, corrected TIMI frame count (cTFC) and residual cumulative ST segment deviation all showed a linear relationship with peak creatine kinase MB (CK-MB), considered as gold standard for infarction size.…”

“…Yet, most RCTs have relied on validated angiographic or electrocardiographic surrogate markers or myocardial perfusion 15 . De Luca et al 15 reported that TMPG, corrected TIMI frame count (cTFC) and residual cumulative ST segment deviation all showed a linear relationship with peak creatine kinase MB (CK-MB), considered as gold standard for infarction size. Patients with the combined presence of a residual ST segment deviation of 0-2 mm, cTFC ≤ 14 and TMPG 3 had a very small infarction and good postdischarge left ventricular ejection fraction (LVEF).…”

Pre-angiography total ST-segment resolution is not a reliable predictor of an open infarct-related artery

“…Based on the results of thrombolytic trials, STSR was identified as a simple, noninvasive diagnostic tool capable of quantifying the magnitude of myocardial reperfusion. Several cutoffs and timeframes of prognostic value were proposed and the relationships between STSR and the patients outcome were documented [2,[8][9][10].…”