Relation of corrected thrombolysis in myocardial infarction frame count and ST-segment resolution to myocardial tissue perfusion after acute myocardial infarction

Chun-Mei Li, Xing-Hua Zhang, Xiao-Jing Ma, Xing-Lei Zhu
Catheterization and Cardiovascular Interventions 2008 February 15, 71 (3): 312-7

OBJECTIVES: To evaluate myocardial tissue perfusion by corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) and ST-segment resolution after successful percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).

BACKGROUND: Early and sustained potency of infarct-related artery (IRA) has become the main goal of reperfusion therapy in patients with AMI. However, myocardial tissue perfusion may remain impaired even after the achievement of TIMI grade 3 flow of the epicardial artery without residual stenosis.

METHODS: CTFC was measured after successful PCI in 63 patients with first AMI. The extent of ST-segment resolution was recorded 1 hr after reperfusion therapy. The wall motion score index (WMSI) was assessed before and 1 month after PCI. Then we studied the correlation between CTFC, ST-segment resolution, and WMSI.

RESULTS: According to CTFC, the patients with TIMI grade 3 flow after PCI were divided into two groups: CTFC fast group and CTFC slow group. CTFC fast group had higher percentage of complete ST resolution (54.1% vs. 25.0%, P < 0.05) and lower percentage of no ST resolution (2.6% vs. 29.2%, P < 0.05). Improvement of WMSI in the CTFC fast group was significantly greater than that of the CTFC slow group (1.30 +/- 0.41 vs. 0.64 +/- 0.30, P < 0.05). CTFC had a significant negative correlation with the change in WMSI (r = -0.75, P < 0.01).

CONCLUSIONS: Combined with ST-segment resolution, CTFC could predict risk for patients with successful reperfusion therapy after AMI and provide evidence for additional adjunctive treatment.

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