Impact of Postprocedural TIMI Flow on Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction Five Year Follow-Up Results in the Corea-AMI Registry

Dae-Won Kim; Sung-Ho Her; Mahn-Won Park; Jung Sun Cho; Tae-Seok Kim; Hyeonjeong Kang; Doo Sun Sim; Young Joon Hong; Ju Han Kim; Youngkeun Ahn; Kiyuk Chang; Wook-Sung Chung; Ki-Bae Seung; Myung-Ho Jeong; Tai-Ho Rho

doi:10.1536/ihj.16-448

Clinical Studies

Impact of Postprocedural TIMI Flow on Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction

Five Year Follow-Up Results in the Corea-AMI Registry

Dae-Won Kim, Sung-Ho Her, Mahn-Won Park, Jung Sun Cho, Tae-Seok Kim, Hyeonjeong Kang, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Kiyuk Chang, Wook-Sung Chung, Ki-Bae Seung, Myung-Ho Jeong, Tai-Ho Rho

Author information

Dae-Won Kim
Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Sung-Ho Her
Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Mahn-Won Park
Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Jung Sun Cho
Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Tae-Seok Kim
Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Hyeonjeong Kang
Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Doo Sun Sim
Cardiovascular Center, Chonnam National University Hospital, Chonnam National University
Young Joon Hong
Cardiovascular Center, Chonnam National University Hospital, Chonnam National University
Ju Han Kim
Cardiovascular Center, Chonnam National University Hospital, Chonnam National University
Youngkeun Ahn
Cardiovascular Center, Chonnam National University Hospital, Chonnam National University
Kiyuk Chang
Division of Cardiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Wook-Sung Chung
Division of Cardiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Ki-Bae Seung
Division of Cardiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea
Myung-Ho Jeong
Cardiovascular Center, Chonnam National University Hospital, Chonnam National University
Tai-Ho Rho
Division of Cardiology, Seoul St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

Keywords: STEMI, NSTEMI, MACE

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Supplementary material

2017 Volume 58 Issue 5 Pages 674-685

DOI https://doi.org/10.1536/ihj.16-448

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Abstract

This study aimed to evaluate the clinical prognostic implications of postprocedural Thrombolysis in Myocardial Infarction (TIMI) flow in acute myocardial infarction patients. A total of 2796 ST-elevation myocardial infarction (STEMI) and 1720 non ST-elevation myocardial infarction (NSTEMI) patients treated in 8 hospitals affiliated with the Catholic University of Korea and Chonnam National University Hospital were analyzed. The study populations were divided according to the final TIMI flow. The primary outcome were the major adverse cardiac events (MACE), defined as a composite of cardiac deaths (CD), nonfatal myocardial infarctions (MI), and target lesion revascularization (TLR). Over a median follow-up of 3.3 years (minimum 2 to maximum 5 years), MACE and CD occurred more frequently in STEMI patients with TIMI ≤ 2 group than those with TIMI 3 (MACE: adjusted hazard ratio [aHR], 1.962; 95% confidence interval [CI] 1.513 to 2.546, P < 0.001, CD: aHR, 3.154, CI 2.308 to 4.309, P < 0.001). However, there was no significant difference between the two subgroups in NSTEMI (aHR, 0.932; 95% CI 0.586 to 1.484, P = 0.087). In STEMI patients, good postprocedural TIMI flow after PCI was associated with favorable clinical outcomes. And the effect of poor TIMI flow in STEMI was on death, not the components of MACE. Meanwhile, postprocedural TIMI flow had no effect on long-term outcomes in NSTEMI patients.

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