Document Detail

Myocardial blush grade: a predictor for major adverse cardiac events after primary PTCA with stent implantation for acute myocardial infarction.
MedLine Citation:
PMID:  17982964     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Optimal myocardial reperfusion is of great importance for survival of patients with AMI undergoing PTCA. According to the Thrombolysis In Myocardial Infarction (TIMI) 3 score, restoration of epicardial flow is achieved in the majority of patients. However, the myocardial blush grade (MBG) may offer additional information for survival. Therefore, we sought to determine whether myocardial blush grades were associated with MACE during follow-up in a high-risk AMI population undergoing primary PTCA with stent implantation. METHODS: Hundred-and-thirty patients with AMI underwent PTCA with stent implantation from 1999 to 2004. The clinical, angiographic and follow-up data were extracted from the hospital records. Apart from the availability and technical adequacy of the angiograms for angiographic analysis, there were no exclusion criteria. RESULTS: Post-procedural TIMI 3 flow was achieved in 103 (79%) patients, while MBG-3 was observed in only 44 (34%) patients. Less post-intervention AMI, cardiac deaths or any MACE occurred in patients with MBG 3 (4/44) compared with MBG 1 or 2 (36/86) (P < 0.01). MBG 3 was a strong predictor of absence of MACE during 5-year follow-up (P < 0.01), whereas no association was found between TIMI 3 and event-free survival (P > 0.5) in our population. CONCLUSION: Our data show that (1) MBG 3 is an important marker for survival and (2) the predictive value of MBG is superior to the TIMI flow grades. Given the predictive validity of MBG shown for MACE-free survival and low rate of MBG 3 despite achievement of TIMI 3 flow, a prospective study with adjunctive therapies to enhance myocardial perfusion is warranted.
Mehmet G Kaya; Fatih Arslan; Adnan Abaci; Geert van der Heijden; Timur Timurkaynak; Atiye Cengel
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  62     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-11-06     Completed Date:  2008-02-08     Revised Date:  2009-06-11    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  445-51     Citation Subset:  IM    
Department of Cardiology, Gazi University Medical School, Ankara, Turkey.
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MeSH Terms
Acute Disease
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Circulation*
Middle Aged
Myocardial Infarction / mortality,  surgery*
Myocardial Reperfusion*
Prospective Studies
Risk Factors
Treatment Outcome*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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