PMID- 15309006
OWN - NLM
STAT- MEDLINE
DCOM- 20050113
LR  - 20161124
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 148
IP  - 2
DP  - 2004 Aug
TI  - Angiographic perfusion score: an angiographic variable that integrates both 
      epicardial and tissue level perfusion before and after facilitated percutaneous 
      coronary intervention in acute myocardial infarction.
PG  - 336-40
AB  - BACKGROUND: Both epicardial and myocardial perfusion have been associated with 
      clinical outcomes in the setting of ST elevation myocardial infarction (STEMI), 
      and the performance of adjunctive/rescue percutaneous coronary intervention (PCI) 
      may further improve clinical outcomes after fibrinolytic administration. METHODS: 
      The goal was to develop a simple, broadly applicable angiographic metric that 
      takes into account indices of epicardial and myocardial perfusion both before and 
      after PCI to arrive at a single perfusion grade in patients undergoing cardiac 
      catheterization after fibrinolysis. The angiographic perfusion score (APS) is the 
      sum of the Thrombolysis in Myocardial Infarction (TIMI) flow grade (TFG; 0-3) 
      added to the TIMI myocardial perfusion grade (TMPG; 0-3) before and after PCI 
      (total possible grade, 0-12). Failed perfusion was defined as an APS of 0 to 3, 
      partial perfusion was defined as an APS of 4 to 9, and full perfusion was defined 
      as an APS of 10 to 12. The APS was evaluated in patients from the Double-blind, 
      Placebo-contolled, Multicenter Angiographic Trial of Rhumab CD18 in Acute 
      Myocardial Infarction (LIMIT-AMI; n = 394) and Enoxaparin as Adjunctive 
      Antithrombin Therapy for ST-Elevation Myocardial Infarction-Thrombolysis In 
      Myocardial Infarction (ENTIRE-TIMI) 23 trials (n = 483), and infarct size 
      (120-216 hours after AMI SPECT Technetium-99m Sestamibi data) was assessed in the 
      LIMIT-AMI trial. RESULTS: The APS was associated with the incidence of death or 
      myocardial infarction (failed, 16.7% [n = 18]; partial, 2.5% [n = 155]; full, 
      2.4% [n = 82]; P =.039 for trend) and larger SPECT infarct sizes (failed, median 
      39% [n = 10]; partial, 12% [n = 79]; and full, 8% [n = 35]; P =.002). No patient 
      with full APS died, whereas the mortality rate was 11.1% in patients with a 
      failed APS (P =.03). CONCLUSIONS: The APS combines grades of epicardial and 
      tissue level perfusion before and after PCI or at the end of diagnostic cardiac 
      catheterization to arrive at a single angiographic variable that is associated 
      with infarct size and the rates of 30-day death or MI. Partial or full 
      angiographic perfusion scores are associated with a halving of infarct size, and 
      no patients with full angiographic perfusion died.
FAU - Gibson, C Michael
AU  - Gibson CM
AD  - TIMI Study Group, the Department of Medicine, Brigham & Women's Hospital, Boston, 
      Mass., USA.
FAU - Murphy, Sabina A
AU  - Murphy SA
FAU - Morrow, David A
AU  - Morrow DA
FAU - Aroesty, Julian M
AU  - Aroesty JM
FAU - Gibbons, Raymond J
AU  - Gibbons RJ
FAU - Gourlay, Steven G
AU  - Gourlay SG
FAU - Barron, Hal V
AU  - Barron HV
FAU - Giugliano, Robert P
AU  - Giugliano RP
FAU - Antman, Elliott M
AU  - Antman EM
FAU - Braunwald, Eugene
AU  - Braunwald E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Angioplasty, Balloon, Coronary
MH  - Cardiac Catheterization
MH  - *Coronary Angiography
MH  - *Coronary Circulation
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*diagnostic imaging/mortality/physiopathology/therapy
MH  - Prognosis
MH  - Randomized Controlled Trials as Topic
MH  - Thrombolytic Therapy
MH  - Treatment Outcome
EDAT- 2004/08/17 10:00
MHDA- 2005/01/14 09:00
CRDT- 2004/08/17 10:00
PHST- 2004/08/17 10:00 [pubmed]
PHST- 2005/01/14 09:00 [medline]
PHST- 2004/08/17 10:00 [entrez]
AID - S0002870304002662 [pii]
AID - 10.1016/j.ahj.2003.12.044 [doi]
PST - ppublish
SO  - Am Heart J. 2004 Aug;148(2):336-40. doi: 10.1016/j.ahj.2003.12.044.