Relationship between corrected TIMI frame counts at three weeks and late survival after myocardial infarction

French, John K.; Hyde, T. A.; Straznicky, Ivan T.; Andrews, Jacqueline; Lund, Mayanna; Amos, D.; Zambanini, Andrew; Ellis, Christopher J.; Webber, Bruce; McLaughlin, S C; Whitlock, R. M. L.; Manda, Samuel; Patel, Hitesh; White, Harvey D.

doi:10.1016/s0735-1097(00)00577-5

Cited by 31 publications

(13 citation statements)

References 24 publications

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“…7,8,10,[25][26][27][28][29][30] Flow in the infarctrelated artery in survivors is significantly faster than in patients who die (49.5 versus 69.6 frames; Pϭ0.0003). 8 Mortality increases by 0.7% for every 10-frame rise in CTFC (PϽ0.001).…”

Section: Relation Of the Ctfc To Clinical Outcomesmentioning

confidence: 99%

Coronary and Myocardial Angiography

2004

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A ngiographic assessment of epicardial coronary artery blood flow has played a pivotal role in our understanding of the "time-dependent open artery hypothesis" and in the evaluation of reperfusion strategies over the past 2 decades. [1][2][3][4][5][6][7][8] It has become increasingly apparent, however, that clinical outcomes are not only associated with angiographic flow in the epicardial artery, but also with angiographic flow in the myocardium. 9 -13 To this end, the goal of reperfusion therapies has shifted to include reperfusion downstream at the level of capillary bed, and it might be more appropriate that the hypothesis now be termed "the time dependent open artery and open microvascular hypothesis." The goal of this article is to review angiographic methods used to evaluate myocardial ischemia and infarction and to discuss the insights into the pathophysiology of acute coronary syndromes provided by these angiographic indexes of coronary artery blood flow and myocardial perfusion.

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Section: Relation Of the Ctfc To Clinical Outcomesmentioning

confidence: 99%

Coronary and Myocardial Angiography

2004

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“…The TFC has correlated with other invasive and non-invasive measures of coronary blood flow [13]–[16]. Further, TFC estimates of coronary flow after reperfusion for acute myocardial infarction predict short- and long-term clinical outcomes [17]–[19]. However, the prognostic implication of an abnormal TFC in patients without acute myocardial infarction or obstructive CAD and with suspected microvascular dysfunction remains unclear.…”

Section: Introductionmentioning

confidence: 99%

TIMI Frame Count and Adverse Events in Women with No Obstructive Coronary Disease: A Pilot Study from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE)

et al. 2014

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BackgroundTIMI frame count (TFC) predicts outcomes in patients with obstructive coronary artery disease (CAD); it remains unclear whether TFC predicts outcomes in patients without obstructive CAD.MethodsTFC was determined in a sample of women with no obstructive CAD enrolled in the Women's Ischemia Syndrome Evaluation (WISE) study. Because TFC is known to be higher in the left anterior descending artery (LAD), TFC determined in the LAD was divided by 1.7 to provide a corrected TFC (cTFC).ResultsA total of 298 women, with angiograms suitable for TFC analysis and long-term (6–10 year) follow up data, were included in this sub-study. Their age was 55±11 years, most were white (86%), half had a history of smoking, and half had a history of hypertension. Higher resting cTFC was associated with a higher rate of hospitalization for angina (34% in women with a cTFC >35, 15% in women with a cTFC ≤35, P<0.001). cTFC provided independent prediction of hospitalization for angina after adjusting for many baseline characteristics. In this cohort, resting cTFC was not predictive of major events (myocardial infarction, heart failure, stroke, or all-cause death), cardiovascular events, all-cause mortality, or cardiovascular mortality.ConclusionsIn women with signs and symptoms of ischemia but no obstructive CAD, resting cTFC provides independent prediction of hospitalization for angina. Larger studies are required to determine if resting TFC is predictive of major events in patients without obstructive coronary artery disease.

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“…1,2 Despite restoration of large-vessel flow, tissue perfusion in area at risk frequently continues to be compromised, as shown by myocardial contrast echocardiography, 3,4 flow velocity measurements, [5][6][7][8][9] and assessment of TIMI frame counts 10,11 or myocardial blush. 12,13 Persistent microcirculatory impairment is associated with poor recovery of contractile function [3][4][5][6][7][8][9] and adverse clinical outcome.…”

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confidence: 99%

Randomized Evaluation of the Effects of Filter-Based Distal Protection on Myocardial Perfusion and Infarct Size After Primary Percutaneous Catheter Intervention in Myocardial Infarction With and Without ST-Segment Elevation

et al. 2005

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Background-In acute myocardial infarction, distal embolization of debris during primary percutaneous catheter intervention may curtail microvascular reperfusion of the infarct region. Our randomized trial investigated whether distal protection with a filter device can improve microvascular perfusion and reduce infarct size after primary percutaneous catheter intervention. Methods and Results-We enrolled 200 patients who had angina within 48 hours after onset of pain plus at least 1 of 3 additional criteria: ST-segment elevation, elevated myocardial marker proteins, and angiographic evidence of thrombotic occlusion. Among the patients included (83% men; mean age, 62Ϯ12 years), 100 were randomly assigned to the filter-wire group and 100 to the control group. The primary end point was the maximal adenosine-induced Doppler flow velocity in the recanalized infarct artery; the secondary end point was infarct size estimated by the volume of delayed enhancement on nuclear MRI. ST-segment elevation myocardial infarction was present in 68.5% of the patients; the median time from onset of pain was 6.9 hours. In the filter-wire group, maximal adenosine-induced flow velocity was 34Ϯ17 compared with 36Ϯ20 cm/s in the control group (Pϭ0.46). Infarct sizes, assessed in 82 patients in the filter-wire group and 78 patients in the control group, were 11.8Ϯ9.3% of the left ventricular mass in the filter-wire group and 10.4Ϯ9.4% in the control group (Pϭ0.33). Thirty-day mortality was 2% in filter-wire group and 3% in the control group. Conclusions-The filter wire as an adjunct to primary percutaneous catheter intervention in myocardial infarction with and without ST-segment elevation did not improve reperfusion or reduce infarct size.

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Relationship between corrected TIMI frame counts at three weeks and late survival after myocardial infarction

Abstract: The CTFC three weeks after myocardial infarction was an independent predictor of five-year survival, but not 10-year survival. Although the CTFC provided additional prognostic information within TIMI flow grades, its superiority was not demonstrated.

Cited by 31 publications

References 24 publications

Coronary and Myocardial Angiography

Coronary and Myocardial Angiography

TIMI Frame Count and Adverse Events in Women with No Obstructive Coronary Disease: A Pilot Study from the NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE)

Randomized Evaluation of the Effects of Filter-Based Distal Protection on Myocardial Perfusion and Infarct Size After Primary Percutaneous Catheter Intervention in Myocardial Infarction With and Without ST-Segment Elevation

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