PMID- 33457136
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210119
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 12
IP  - 12
DP  - 2020 Dec 12
TI  - Frequency of Thrombolysis in Myocardial Infarction III Flow in Patients With 
      Primary Percutaneous Coronary Intervention: Not All Culprit Vessels Are 
      Completely Occluded in ST Elevation Myocardial Infarction.
PG  - e12036
LID - 10.7759/cureus.12036 [doi]
LID - e12036
AB  - Background ST elevation myocardial infarction (STEMI) is classically 
      characterized by total occlusion of the culprit coronary artery. However during 
      primary percutaneous coronary intervention (PCI) thrombolysis in myocardial 
      infarction (TIMI) 0 flow is not observed in all patients' culprit arteries in 
      angiographic views. This study was conducted to find out the frequency of TIMI 
      flow in acute STEMI patients in view of the above concept. The aim of this study 
      was to evaluate the frequency of pre-procedural TIMI III flow in those patients 
      who underwent primary PCI for acute STEMI in a public sector hospital in Karachi, 
      Pakistan. Methodology This study is an audit of already saved data in the 
      catheterization laboratory of the National Institute of Cardiovascular Diseases 
      (NICVD), Karachi, that was collected prospectively from January 2016 to December 
      2018. These data were collected after taking consent from those patients who 
      presented to hospital within 12 hours of symptoms and underwent primary PCI. Data 
      were entered and analyzed on Statistical Package for the Social Sciences (SPSS) 
      version 19 (IBM Corp., Armonk, NY, USA). Results A total of 8018 patients were 
      included in this study who presented with STEMI and underwent primary PCI. Out of 
      them 80.9% were males. Hypertension was the leading risk factor in 54.1% (4340) 
      of patients. TIMI III flow was present in 11.4% of patients before primary PCI, 
      while TIMI 0, I and II flow were present in 57.1%, 15.1%, and 16.3% of patients 
      respectively (p<0.001). Fourteen percent of patients with TIMI III flow were of 
      age group 51 to 60 years. Among those who had TIMI III flow, 11.2% were those 
      with door to balloon time of <90 minutes. In 11% of cases, left anterior 
      descending (LAD) artery had TIMI III flow as compared to other vessels (p<0.001). 
      The length of the lesion was significantly smaller in patients who had TIMI III 
      flow compared to those who had TIMI 0-II flow. Conclusions This study revealed 
      that not all patients with acute STEMI had totally occluded culprit coronary 
      artery but some of them had angiographic TIMI I-III flow in the infarct-related 
      artery. Further studies are needed to find the reason for re-establishment of 
      flow in the culprit vessel in STEMI patients before PCI.
CI  - Copyright (c) 2020, Hussain et al.
FAU - Hussain, Muhammad
AU  - Hussain M
AD  - Interventional Cardiology, National Institute of Cardiovascular Diseases, 
      Karachi, PAK.
FAU - Kumar, Rajesh
AU  - Kumar R
AD  - Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Ammar, Ali
AU  - Ammar A
AD  - Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Alishan, Syed
AU  - Alishan S
AD  - Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Muhammad, Atif S
AU  - Muhammad AS
AD  - Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Farooq, Fawad
AU  - Farooq F
AD  - Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Saghir, Tahir
AU  - Saghir T
AD  - Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Khan, Naveedullah
AU  - Khan N
AD  - Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
FAU - Hassan Rizvi, Syed N
AU  - Hassan Rizvi SN
AD  - Cardiology, Ziauddin Mefical University, Karachi, PAK.
AD  - Interventional Cardiology, National Institute of Cardiovascular Diseases, 
      Karachi, PAK.
FAU - Ashraf, Tariq
AU  - Ashraf T
AD  - Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
LA  - eng
PT  - Journal Article
DEP - 20201212
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC7797447
OTO - NOTNLM
OT  - coronary artery disease
OT  - infarct related artery
OT  - primary percutaneous coronary intervention
OT  - spontaneous revascularization
OT  - st elevation myocardial infarction
OT  - thrombolysis in myocardial infarction
OT  - vessel patency
COIS- The authors have declared that no competing interests exist.
EDAT- 2021/01/19 06:00
MHDA- 2021/01/19 06:01
PMCR- 2020/12/12
CRDT- 2021/01/18 05:31
PHST- 2021/01/18 05:31 [entrez]
PHST- 2021/01/19 06:00 [pubmed]
PHST- 2021/01/19 06:01 [medline]
PHST- 2020/12/12 00:00 [pmc-release]
AID - 10.7759/cureus.12036 [doi]
PST - epublish
SO  - Cureus. 2020 Dec 12;12(12):e12036. doi: 10.7759/cureus.12036.