Faisal Abdul Wajid Khan, Ali Khurshid, Sadiq Zohaib, Asar Zameer Ul, Latif Waqas, Iqbal Madiha
Abdul Wajid Khan Faisal, FCPS (Medicine); FCPS (Cardiology) Professor of Cardiology, Department of Cardiology, Punjab Institute of Cardiology, Lahore, Pakistan.
Khurshid Ali, FCPS Fellowship in Interventional Cardiology, Cardiologist, DHQ Hospital Batkhela Malakand, Pakistan.
Pak J Med Sci. 2024 Dec;40(11):2583-2587. doi: 10.12669/pjms.40.11.9954.
This study was conducted to evaluate the procedural success of primary angioplasty in terms of TIMI flow and myocardial blush grade (MBG).
We used cross-sectional population data of the patients who underwent primary PCI in Emergency Angiography department of Punjab Institute of Cardiology, Lahore from January 2021 to September 2021. TIMI flow and myocardial blush grades (MBG) were assessed before and after the procedure. All PCIs in which there was improvement in blood flow in infarct related artery of ≥2 grades in TIMI flow and/or in MBG were considered successful.
A total of 106 patients were enrolled, 91 patients were male and 15 patients were female with the age range from 22 to 75 (48.7 ± 11.8) years. TIMI flow and MBG was improved ≥ 2 grades in 69 and 58 patients respectively. Improvement in TIMI flow was noted similar in all three vessels. Overall 65% patients showed improvement in TIMI flow and 55% in MBG. Onset of chest pain to balloon time was the most important parameter, shorter the time better the result. The patients in whom MBG was improved, the time was 234.26 ± 156.06 vs 323.59 ± 252.64 minutes.
Primary angioplasty is quite effective procedure for the restoration of blood flow in acute ST elevation myocardial infarction but still it is far away from the ideal one. Although most patients benefit from primary PCI, a significant minority of individuals do not, particularly if they present late. What could be the ideal therapy, the answer is still to be answered.
本研究旨在根据心肌梗死溶栓治疗(TIMI)血流分级和心肌灌注分级(MBG)评估直接血管成形术的手术成功率。
我们使用了2021年1月至2021年9月在拉合尔旁遮普心脏病学研究所急诊血管造影科接受直接经皮冠状动脉介入治疗(PCI)患者的横断面人群数据。在手术前后评估TIMI血流和心肌灌注分级(MBG)。所有梗死相关动脉血流在TIMI血流分级和/或MBG中改善≥2级的PCI均被视为成功。
共纳入106例患者,其中男性91例,女性15例,年龄范围为22至75岁(48.7±11.8岁)。TIMI血流和MBG分别在69例和58例患者中改善≥2级。在所有三支血管中,TIMI血流的改善情况相似。总体而言,65%的患者TIMI血流有改善,55%的患者MBG有改善。胸痛发作至球囊扩张时间是最重要的参数,时间越短结果越好。MBG有改善的患者,时间为234.26±156.06分钟,而另一组为323.59±252.64分钟。
直接血管成形术是恢复急性ST段抬高型心肌梗死血流的有效方法,但仍远非理想方法。尽管大多数患者从直接PCI中获益,但仍有相当一部分个体未获益,尤其是那些就诊较晚的患者。理想的治疗方法是什么,答案仍有待解答。