Bahrehmand M, Sadeghi E, Shafiee A, Nozari Y
Department of Cardiology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Department of Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
J Med Life. 2015;8(Spec Iss 3):59-65.
Initial percutaneous coronary interference (PCI) is still connected by a noticeable incidence of suboptimal coronary flow thrombolysis in infarction of myocardial (TIMI). The predictors of slow and no-reflow in cases that supported initial PCI in our institute was searched for and the relationship of these parameters with major adverse cardiovascular effects (MACE) was assessed. 397 patients with AMI displaying in 24 hours of the sign opening were retrospectively enrolled and underwent primary PCI between March 2006 and March 2012. Demographic, clinical, and procedural data were retrieved from our institutional databank. The baseline and post-PCI flow of blood in the revascularized artery was ranked based on the TIMI grading method. The follow-up visits were performed after one, six and twelve month from hospitalization. All the mortalities and complications were recorded within this period for evaluate the MACE. The frequency of diabetes mellitus and renal failure were importantly larger in cases with a TIMI flow of 0-1 (p=0.03 & p=.01, respectively). Similarly, level of serum creatine were importantly larger in cases with a TIMI flow of 0-1. The predictors for TIMI flow included that utilize of Adenosin or Integrilin, diabetes mellitus, POIT, long tubular lesion, and injury at LAD territory. The incidence of MACE was significantly higher in patients with a TIMI flow of 0-1 (P=0.001) and the survival in this subgroup was significantly poorer (Hazard ratio=4.96; P<0.001). A low TIMI flow is accompanied by a poorer survival and a higher MACE and is influenced by some clinical and vascular characteristics.
初始经皮冠状动脉介入治疗（PCI）后仍有相当比例的患者出现心肌梗死溶栓治疗心肌梗死分级（TIMI）血流未达最佳状态。本研究旨在寻找我院支持初始PCI治疗患者中慢血流和无复流的预测因素，并评估这些参数与主要不良心血管事件（MACE）的关系。回顾性纳入2006年3月至212012年3月期间397例发病24小时内就诊并接受直接PCI的急性心肌梗死（AMI）患者。从我院数据库中获取人口统计学、临床和手术数据。根据TIMI分级方法对血管重建术后动脉的基线和PCI后血流进行分级。住院后1个月、6个月和12个月进行随访。记录该期间内所有死亡和并发症情况以评估MACE。TIMI血流为0 - 1级的患者中糖尿病和肾衰竭的发生率显著更高（分别为p = 0.03和p = 0.01）。同样，TIMI血流为0 - 1级的患者血清肌酐水平也显著更高。TIMI血流的预测因素包括使用腺苷或依替巴肽、糖尿病、POIT、长管状病变以及左前降支区域损伤。TIMI血流为0 - 1级的患者MACE发生率显著更高（P = 0.001），该亚组患者的生存率显著更低（风险比=4.96；P < 0.001）。低TIMI血流与较差的生存率和较高的MACE相关，并受一些临床和血管特征的影响。
