Document Detail

Incidence and importance of thrombolysis in myocardial infarction grade 3 flow after primary percutaneous transluminal coronary angioplasty for acute myocardial infarction.
MedLine Citation:
PMID:  8831393     Owner:  NLM     Status:  MEDLINE    
We analyzed angiographic flow and myocardial salvage in 180 patients who underwent primary percutaneous transluminal coronary angioplasty (PTCA) without antecedent thrombolytic therapy for acute myocardial infarction. Thrombolysis in Myocardial Infarction (TIMI) flow grade was analyzed visually before and after PTCA. All patients underwent paired baseline (before angioplasty) and predischarge quantitative tomographic perfusion imaging with technetium-99m (Tc-99m) sestamibi techniques for assessment of the initial area at risk and final infarct size. The myocardial salvage index was defined as the proportion of jeopardized myocardium that was salvaged. After primary PTCA, TIMI grade 3 flow was obtained in 163 patients (91%), TIMI grade 2 flow in 13 patients (7%), and TIMI grade 0 or 1 flow in 4 patients (2%). There was a significant association between TIMI flow and both infarct size and salvage index. Infarct size was significantly smaller in patients with TIMI grade 3 flow than in those with TIMI grade 2 flow (15 +/- 16% vs 29 +/- 21% of left ventricular mass, p = 0.007). The salvage index was 55 +/- 41% of the area at risk in the TIMI 3 group and 27 +/- 38% of the area at risk in the TIMI 2 group (p = 0.04). After primary PTCA, restoration of TIMI grade 3 flow was necessary for optimal myocardial salvage. TIMI grade 2 flow was associated with a larger final infarct size and a lower salvage index.
S B Laster; J H O'Keefe; R J Gibbons
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1996-10-29     Completed Date:  1996-10-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  623-6     Citation Subset:  AIM; IM    
Cardiovascular Consultants, P.C., Kansas City, Missouri 64111, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Middle Aged
Myocardial Infarction / drug therapy,  pathology,  physiopathology*,  radionuclide imaging,  therapy*
Severity of Illness Index
Technetium Tc 99m Sestamibi / diagnostic use
Thrombolytic Therapy*
Treatment Outcome
Reg. No./Substance:
109581-73-9/Technetium Tc 99m Sestamibi

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