Temporal trends in the pre-procedural TIMI flow grade among patients with ST- segment elevation myocardial infarction – From the ACSIS registry

Pravda, Nili Schamroth; Cohen, Tal; Klempfner, Robert; Kornowski, Ran; Beigel, Roy; Orvin, Katia; Abitbol, Merry; Pravda, Miri Schamroth; Dobrecky‐Mery, Idit; Rubinshtein, Ronen; Saada, Majdi; Eisen, Alon

doi:10.1016/j.ijcha.2021.100868

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…Percutaneous coronary intervention (PCI) has become accepted as the preferred reperfusion strategy in acute ST-segment elevation myocardial infarction (STEMI) as it results in lower rates of death, reinfarction and stroke compared to fibrinolysis [ 1 , 2 ]. Despite its imperfections, Thrombolysis in Myocardial Infarction (TIMI) coronary flow grade is a validated scale used to assess epicardial perfusion on coronary angiography due to the objectivity of the results in the assessment of blood flow to distal epicardial arterial circulation depending on individual operators [ 3 ]. TIMI 0 and 1 flow grade were found as lack of coronary artery patency, TIMI flow grade 2 as impaired blood flow with preserved patency, and TIMI flow grade 3 as normal blood flow [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction

Maruszak,

Pilch,

Januszek

et al. 2023

JPM

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Background and aims: Primary percutaneous coronary intervention (PCI) is regarded as the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). Thrombolysis in Myocardial Infarction (TIMI) flow grade has been an important and cohesive predictor of outcomes in STEMI patients. We sought to evaluate potential variables associated with the risk of suboptimal TIMI flow after PCI in patients with anterior wall STEMI. Methods: We evaluated 107 patients admitted to our hospital between 1 January 2019 and 31 December 2021 with a diagnosis of anterior wall STEMI treated with primary PCI. Results: Suboptimal TIMI flow grade (≤2) after PCI occurred in 14 (13%) patients while grade 3 was found in 93 (87%) of them presenting with anterior wall STEMI. Failure to achieve optimal TIMI 3 flow grade after PCI was associated with lower TIMI grade prior to PCI (OR 0.5477, 95% CI 0.2589–0.9324, p = 0.02), greater troponin concentration before (OR 1.0001, 95% CI 1–1.0001, p = 0.0028) and after PCI (OR 1.0001, 95% CI 1–1.0001, p = 0.0452) as well as lower mean minimal systolic blood pressure (OR 0.9653, 95% CI 0.9271–0.9985, p = 0.04). Conclusions: Among predictors of suboptimal TIMI flow grade after PCI, we noted lower TIMI grade flow pre-PCI, greater serum troponin concentrations in the periprocedural period and lower mean minimal systolic blood pressure.

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Section: Introductionmentioning

confidence: 99%

Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction

Maruszak,

Pilch,

Januszek

et al. 2023

JPM

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A Case of Grade III Obesity in the Elderly Combined with Multisystem Disease Patient Underwent Sleeve Gastrectomy Nursing Throughout Hospitalization

Hu,

Lin,

Lai

et al. 2024

AJNS

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Background: Obesity is a complex, multifactorial disease that has a negative impact on health. In 2020, obesity affects about 42% of the global population, and the prevalence of overweight and obesity in Chinese adults is expected to reach 61% by 2030. Methods: Summarize the nursing experience of a case of elderly grade III obesity combined with multisystem disease treated with laparoscopic sleeve gastrectomy. Nursing points include acute heart failure care, coronary heart disease care, obesity other related comorbidities care, skin care, medication care, SG perioperative care, nutritional care, pipeline care, anticipatory psychological care and health education. Results: After the patient underwent individualized treatment and nursing, his vital signs were stable, the abdominal incision healed well, no adverse events occurred during hospitalization, and he was discharged smoothly 11d after surgery. Conclusion: This patient has a variety of metabolic diseases, during hospitalization, we should track the patient's examination and laboratory tests, and pay attention to their physical and psychological care. Older people due to the degradation of various physiological systems, their metabolic function and the poor ability to respond to various diseases, the weight loss effect may be not as good as that of young patients. It is necessary to explain the patients and a longer follow-up time to observe the weight loss effect.

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Prognostic impact of pre-interventional culprit artery thrombolysis in myocardial infarction (TIMI) flow in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention

et al. 2022

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Background Primary percutaneous coronary intervention (PCI) is considered the most preferred strategy in ST-segment elevation myocardial infarction (STEMI). However, the prognostic role of spontaneous re-canalization in STEMI patients is still not clear. The purpose of this study is to evaluate the impact of pre-procedural TIMI flow grade in the culprit coronary artery on the short and long term prognosis in Egyptian patients presented with STEMI and treated with primary PCI. Results A dual center, prospective observational study that was conducted in the period from January 2019 till June 2020 and enrolled 150 STEMI patients presented within 24 h from onset of chest pain. Initial angiography was done with analysis of TIMI flow grade in the infarct related artery. Of the 150 enrolled patients; 93 patients (62%) were found to have initial TIMI flow grade 0 (group A) and 57 patients (38%) had initial TIMI flow grade I–III (group B). There was a strong association between cardiac mortality and pre-procedural TIMI flow grade. 12 mortalities (8% of total study population) were recorded during our study period; in-hospital mortality was reported in 7 patients in group A, yet no mortalities were recorded in-hospital in group B (P value = 0.033). At 1 year follow up; 5 mortalities were recorded in group A with no mortalities at all in group B (P value = 0.005). There was a trend towards an increase in acute heart failure incidence in group A yet no statistically significant value was achieved (P value = 0.112). Target lesion revascularization was reported in 8 patients in group A and in only 3 patients in group B (P value 0.446). Conclusions Despite the evolution in primary PCI strategies and the continuous advancement in anti-thrombotic treatment; pre-interventional infarct related artery TIMI flow grade I–III is associated with better in hospital and 1 year outcome, specifically significantly lower cardiac mortality compared to patients who had TIMI flow grade 0 at initial angiography.

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Temporal trends in the pre-procedural TIMI flow grade among patients with ST- segment elevation myocardial infarction – From the ACSIS registry

Cited by 4 publications

References 17 publications

Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction

Risk Factors of Suboptimal Coronary Blood Flow after a Percutaneous Coronary Intervention in Patients with Acute Anterior Wall Myocardial Infarction

A Case of Grade III Obesity in the Elderly Combined with Multisystem Disease Patient Underwent Sleeve Gastrectomy Nursing Throughout Hospitalization

Prognostic impact of pre-interventional culprit artery thrombolysis in myocardial infarction (TIMI) flow in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention

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