The utility of the TIMI risk index on admission for predicting angiographic no-reflow after primary percutaneous coronary intervention in patients with STEMI

Authors: HALİT ACET, FARUK ERTAŞ, MEHMET ATA AKIL, MEHMET ZİHNİ BİLİK, MESUT AYDİN, NİHAT POLAT, ABDULKADİR YILDIZ, MURAT YÜKSEL, LEYLA ÇİFTÇİ, NECDET ÖZAYDOĞDU, MEHMET ÖZBEK, SAİT ALAN, NİZAMETTİN TOPRAK

Abstract: Background/aim: The thrombolysis in myocardial infarction (TIMI) risk score (TRS), and the TIMI risk index (TRI) have been reported in coronary artery disease patients. We investigated whether admission TRI is associated with no-reflow (NRF) in patients undergoing primary percutaneous coronary intervention (p-PCI). Materials and methods: ST-segment elevation myocardial infarction (STEMI) patients treated with p-PCI were included in the study. TRI was calculated on admission using specified variables. We defined the angiographic NRF phenomenon as a coronary TIMI flow grade of ≤2 after the vessel was recanalized or a TIMI flow grade of 3 together with a final myocardial blush grade (MBG) of <2 in a manner as described in previous studies. Results: A total of 371 patients (aged 62 ± 14 years; 73/27 men to women ratio) who underwent p-PCI were enrolled in the study. In terms of age, NRF patients were older than reflow patients (P < 0.017 for MBG). Killip class III-IV designations were more common in NRF patients (P = 0.029 for MBG). TRI (P = 0.014 for MBG) values were significantly greater in the NRF group. TRI was an independent predictor of NRF according to MBG flow (P = 0.003, B = -0.035, Exp B = 0966, 95% CI, 0.944-0.988). Conclusion: Admission TRI may predict the development of NRF phenomenon after p-PCI in patients with acute STEMI.

Keywords: ST-segment elevation myocardial infarction, global registry of acute coronary events risk score, thrombolysis in myocardial infarction risk score, thrombolysis in myocardial infarction risk index, no-reflow phenomenon, primary percutaneous coronary intervention

Full Text: PDF