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ȣ - 550928 63 |
Clinical impact of initial TIMI 3 flow on 1-year MACE in patients with ST-segment elevation myocardial infarction |
충남대학교의학전문대학원 충남대학교병원1, 전남대학교병원2, 경북대학교병원3, 계명대학교병원4, 전북대학교병원5, 영남대학교병원6, 전주예수병원7 |
정진옥1, 박용규1, 진선아1, 박수진1, 김준형1, 박재형1, 이재환1, 최시완1, 정명호2, 채성철3, 허승호4, 채제건5, 김영조6, 류제영7, 성인환1 외 Korea Acute Myocardial Infarction Registry 연구자 |
Background: Thrombolysis In Myocardial Infarction (TIMI) flow after primary percutaneous coronary intervention (PCI) is an important prognostic factor in patients with ST-segment elevation acute myocardial infarction (STEMI). We reviewed TIMI flow (pre and post PCI) in patients with STEMI and analyzed clinical outcomes.
Methods: From the Korea Acute Myocardial Infarction Registry, 2,982 patients with STEMI who were undergoing primary PCI within 12hours (61.4±12.8 years, 25.6% women) were enrolled between October 2005 and February 2008. The patients were divided into two groups according to initial TIMI flow: group I (preTIMI 0, 1, 2, n=2587) and group II (preTIMI 3, n=395). Also we analyzed the impact of final TIMI flow. In hospital mortality rates and 1-year mortality and major adverse cardiac event (MACE) rates were compared between two groups.
Results: Initial TIMI 3 flow was significantly related lower 1- year MACE compared to others (14.9% vs 20.3%, p=0.024). There was a trend decreased rate of 1- year repeated PCI in initial TIMI 3 flow group (6.1% vs 9.3%, p=0.059). There were no significant differences in 1-year mortality, recurrence of MI according to initial TIMI flow. In-hospital mortality rates(3.5% vs 19.1%, p<0.0001) 1-year mortality (8.4% vs 30.5%, p<0.0001)and 1-year MACE (17.7% vs 40%, p<0.0001) was significantly lower in final TIMI 3 group than others. There were no significant differences in 1-year recurrence of MI, repeated PCI according to final TIMI 3 flow.
Conclusions: This study demonstrates that initial TIMI 3 flow significantly decrease 1-year MACE and final TIMI 3 flow significantly decrease in-hospital mortality, 1-year mortality, 1-year MACE rate in patients with STEMI in Korea.
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Initial TIMI 0,1,2 |
Initial TIMI 3 |
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Final TIMI 0,1,2 |
Final TIMI 3 |
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In-hospital mortality |
5.0% |
3.3% |
p=ns |
19.1% |
3.5% |
p<0.0001 |
1-year mortality |
10.7% |
8.3% |
p=ns |
30.5% |
8.4% |
p<0.0001 |
1-year MACE |
20.3% |
14.9% |
p=0.024 |
40.0% |
17.7% |
p<0.0001 |
1-year TVR |
9.3% |
6.1% |
p=0.059 |
8.9% |
8.9% |
p=ns |
1-year MI |
0.4% |
0.6% |
p=ns |
0.6% |
0.4% |
p=ns |
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