Background: Thrombolysis In Myocardial Infarction (TIMI) flow after primary percutaneous coronary intervention (PCI) is an important prognostic factor in patients with ST-segment elevation acute myocardial infarction (STEMI). We reviewed TIMI flow (pre and post PCI) in patients with STEMI and analyzed clinical outcomes.
Methods: From the Korea Acute Myocardial Infarction Registry, 2,982 patients with STEMI who were undergoing primary PCI within 12hours (61.4짹12.8 years, 25.6% women) were enrolled between October 2005 and February 2008. The patients were divided into two groups according to initial TIMI flow: group I (preTIMI 0, 1, 2, n=2587) and group II (preTIMI 3, n=395). Also we analyzed the impact of final TIMI flow. In hospital mortality rates and 1-year mortality and major adverse cardiac event (MACE) rates were compared between two groups.
Results: Initial TIMI 3 flow was significantly related lower 1- year MACE compared to others (14.9% vs 20.3%, p=0.024). There was a trend decreased rate of 1- year repeated PCI in initial TIMI 3 flow group (6.1% vs 9.3%, p=0.059). There were no significant differences in 1-year mortality, recurrence of MI according to initial TIMI flow. In-hospital mortality rates(3.5% vs 19.1%, p<0.0001) 1-year mortality (8.4% vs 30.5%, p<0.0001)and 1-year MACE (17.7% vs 40%, p<0.0001) was significantly lower in final TIMI 3 group than others. There were no significant differences in 1-year recurrence of MI, repeated PCI according to final TIMI 3 flow.
Conclusions: This study demonstrates that initial TIMI 3 flow significantly decrease 1-year MACE and final TIMI 3 flow significantly decrease in-hospital mortality, 1-year mortality, 1-year MACE rate in patients with STEMI in Korea.