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, = 0.02), greater troponin concentration before (OR 1.0001, 95% CI 1-1.0001, = 0.0028) and after PCI (OR 1.0001, 95% CI 1-1.0001, = 0.0452) as well as lower mean minimal systolic blood pressure (OR 0.9653, 95% CI 0.9271-0.9985, = 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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http://dx.doi.org/10.3390/jpm13081217 | DOI Listing |
Background: The prevalence of coronary chronic total occlusion (CTO) in coronary angiography (CAG) has risen with ageing populations, along with the expansion of CTO percutaneous coronary interventions (CTO-PCI). However, CTO-PCI encounters challenges such as undersized stents, dissection risks, and limited access to intravascular imaging (IVI), particularly in regions with limited health budgets. This study introduces the 'GIVE IT TIME TO SOBER UP - GITSU strategy', a two-session CTO-PCI approach where Thrombolysis in Myocardial Infarction (TIMI-3) antegrade flow is achieved without stent placement in the first session.
View Article and Find Full Text PDFCoron Artery Dis
January 2025
Department of Cardiovascular Medicine, Assiut University Heart Hospital, Assiut, Egypt.
Background: No-reflow following primary percutaneous coronary intervention (PPCI) is challenging to treat.
Objectives: The objective of this study is to evaluate the efficacy and safety of upstream high-bolus-dose tirofiban administration in ST-segment elevation myocardial infarction (STEMI) cases undergoing PPCI on top of dual antiplatelet therapy, including ticagrelor, in comparison to selective bailout administration.
Methods: This hospital-based, randomized, single-blinded prospective interventional study was conducted on 150 patients at Assiut University Heart Hospital.
Angiology
January 2025
Department of Cardiology, University of Health Sciences Ankara City Hospital, Ankara, Turkey.
Contrast-induced nephropathy (CIN) poses a significant risk following primary percutaneous coronary intervention (pPCI) in patients with ST-Elevation Myocardial Infarction (STEMI). Magnesium (Mg²⁺) deficiency has been associated with renal dysfunction and cardiovascular diseases, yet its role in CIN development remains unclear. This study represents the first investigation exploring the relationship between Mg²⁺ levels and CIN in this context.
View Article and Find Full Text PDFNeth Heart J
January 2025
Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
Cardiovasc Interv Ther
January 2025
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama City, 330-8503, Japan.
This study aimed to investigate the relationship between the restoration of coronary flow just before stent deployment and the final thrombolysis in myocardial infarction (TIMI) flow grade 3 in patients with ST-segment elevation myocardial infarction (STEMI) whose initial TIMI flow grade ≤ 1. In primary percutaneous coronary intervention (PCI), initial TMI flow grade ≤ 1 is closely associated with suboptimal final TIMI flow grade. We included 466 STEMI patients with initial TIMI flow grade ≤ 1 and divided into a restored flow group or an unrestored flow group according to the TIMI flow grade just before stent deployment.
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