We investigated the value of angiographic parameters in patients with successful primary angioplasty using a simple angiographic risk score. In 608 consecutive patients, we assessed the infarct-related artery, antegrade flow before treatment, presence of distal embolization, and myocardial blush grade after coronary angioplasty. LAD-related infarction (OR = 8.4; 3 points), TIMI 0-2 flow before angioplasty (OR = 2.2; 1 point), myocardial blush 0 or 1 (OR = 2.5; 1 point), and distal embolization (OR = 2.2; 1 point) were independent predictors of left ventricular ejection fraction (LVEF) < or = 40% after successful angioplasty. Patients with 0 (minimum) or 1 point have LVEF of 49.5% +/- 8.4% and 30-day mortality of 0.8%. Patients with 2-3 points have LVEF of 44.9% +/- 10.3% and 30-day mortality of 2.8%. Patients with 4 points have LVEF of 38.2% +/- 10.8% and 30-day mortality of 2.7%. Patients with 5-6 (maximum) points have LVEF of 32.0% +/- 9.4% and 30-day mortality of 6.9%. A simple angiographic score predicts LVEF and mortality in patients when leaving the catheterization laboratory after successful primary angioplasty for acute myocardial infarction.
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