International journal of cardiology · 2012
Implications of pre-procedural TIMI flow in patients with non ST-segment elevation acute coronary syndromes undergoing percutaneous coronary revascularization: insights from the ACUITY trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
De Luca Giuseppe, Brener Sorin J, Mehran Roxana, Lansky Alexandra J, McLaurin Brent T, Cox David A, Cristea Ecaterina, Fahy Martin, Stone Gregg W
Аннотация
OBJECTIVES: The purpose of this study was to evaluate the prognostic implications of preprocedural TIMI flow in ACS patients undergoing early invasive management.
BACKGROUND: Although the negative prognostic impact of reduced Thrombolysis in Myocardial Infarction (TIMI) flow before percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) has been well described, whether this relationship holds in patients with acute coronary syndromes (ACS; unstable angina and non-STEMI) has not been examined.
METHODS: We evaluated 3582 moderate and high-risk patients with ACS undergoing PCI enrolled in the ACUITY trial. Patients were divided in 3 groups according to pre-procedural culprit vessel TIMI flow (TIMI 0/1, TIMI 2 and TIMI 3 flows), determined by an independent angiographic core laboratory.
RESULTS: Baseline culprit vessel flow was absent (TIMI 0/1) in 453 patients (12.6%), reduced (TIMI 2) in 389 patients (10.9%) and normal (TIMI 3) in 2740 patients (76.5%) patients. Post-PCI TIMI 3 flow was achieved in 87.2%, 86.8% and 98.8% of the 3 groups, respectively (P<0.0001). At 1 year, mortality occurred in 2.7%, 2.4% and 3.0% of patients with baseline TIMI 0/1, 2 and 3 flows, respectively (P=0.82). By multivariable analysis, pre-PCI TIMI flow 0/1 (vs. TIMI 3) was not an independent predictor of 1-year mortality (P=0.61).
CONCLUSIONS: Reduced baseline TIMI flow in moderate and high-risk patients with ACS undergoing PCI does not appear to affect survival at 1 year, in contrast to that described in patients with STEMI.
BACKGROUND: Although the negative prognostic impact of reduced Thrombolysis in Myocardial Infarction (TIMI) flow before percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) has been well described, whether this relationship holds in patients with acute coronary syndromes (ACS; unstable angina and non-STEMI) has not been examined.
METHODS: We evaluated 3582 moderate and high-risk patients with ACS undergoing PCI enrolled in the ACUITY trial. Patients were divided in 3 groups according to pre-procedural culprit vessel TIMI flow (TIMI 0/1, TIMI 2 and TIMI 3 flows), determined by an independent angiographic core laboratory.
RESULTS: Baseline culprit vessel flow was absent (TIMI 0/1) in 453 patients (12.6%), reduced (TIMI 2) in 389 patients (10.9%) and normal (TIMI 3) in 2740 patients (76.5%) patients. Post-PCI TIMI 3 flow was achieved in 87.2%, 86.8% and 98.8% of the 3 groups, respectively (P<0.0001). At 1 year, mortality occurred in 2.7%, 2.4% and 3.0% of patients with baseline TIMI 0/1, 2 and 3 flows, respectively (P=0.82). By multivariable analysis, pre-PCI TIMI flow 0/1 (vs. TIMI 3) was not an independent predictor of 1-year mortality (P=0.61).
CONCLUSIONS: Reduced baseline TIMI flow in moderate and high-risk patients with ACS undergoing PCI does not appear to affect survival at 1 year, in contrast to that described in patients with STEMI.