Although there is an excellent outcome conferred by primary PCI in patients with STEMI, the prognostic role of spontaneous re-canalization in these patients is still not clear. However, the prognostic role of early spontaneous re-canalization before undergoing angioplasty in these patients has not been thoroughly investigated. Primary percutaneous coronary intervention (PCI) has been shown to improve the outcome of patients with ST-segment elevation myocardial infarction (STEMI) in comparison to thrombolysis, mainly due to restoration of angiographic thrombolysis in myocardial infarction (TIMI) III flow grade in the vast majority of patients with further improvement of adjunctive pharmacological agents and mechanical devices. Conclusionsĭespite the evolution in primary PCI strategies and the continuous advancement in anti-thrombotic treatment pre-interventional infarct related artery TIMI flow grade I–III is associated with better in hospital and 1 year outcome, specifically significantly lower cardiac mortality compared to patients who had TIMI flow grade 0 at initial angiography. Target lesion revascularization was reported in 8 patients in group A and in only 3 patients in group B ( P value 0.446). There was a trend towards an increase in acute heart failure incidence in group A yet no statistically significant value was achieved ( P value = 0.112). At 1 year follow up 5 mortalities were recorded in group A with no mortalities at all in group B ( P value = 0.005). 12 mortalities (8% of total study population) were recorded during our study period in-hospital mortality was reported in 7 patients in group A, yet no mortalities were recorded in-hospital in group B ( P value = 0.033). There was a strong association between cardiac mortality and pre-procedural TIMI flow grade. Of the 150 enrolled patients 93 patients (62%) were found to have initial TIMI flow grade 0 (group A) and 57 patients (38%) had initial TIMI flow grade I–III (group B). Initial angiography was done with analysis of TIMI flow grade in the infarct related artery. The purpose of this study is to evaluate the impact of pre-procedural TIMI flow grade in the culprit coronary artery on the short and long term prognosis in Egyptian patients presented with STEMI and treated with primary PCI.Ī dual center, prospective observational study that was conducted in the period from January 2019 till June 2020 and enrolled 150 STEMI patients presented within 24 h from onset of chest pain. However, the prognostic role of spontaneous re-canalization in STEMI patients is still not clear. Primary percutaneous coronary intervention (PCI) is considered the most preferred strategy in ST-segment elevation myocardial infarction (STEMI).
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