De la Cruz OR, Palacios RJM, Muñiz GA, Reyes DS, Jáuregui OO, Ogaz GE

Language: Spanish
References: 24
Page: 155-161
PDF size: 81.62 Kb.

ABSTRACT

Introduction: It is proven that the best outcomes related to adverse events in patients being treated for myocardial infarction are those observed in patients with mechanical reperfusion therapy with percutaneous coronary intervention (PCI), however obtaining an appropriate pattern of coronary flows is fundamental in these treated patients. Objective: To measure the impact of epicardial TIMI flow in patients with ongoing myocardial infarction treated with PCI on mortality during hospitalization and at six months follow up. Methods: 483 patients who were treated with PCI for ongoing myocardial infarction during the period of January of 1996 to January of 2004 where included. Based upon the pattern of epicardial coronary flow they were assigned to one of three groups: A) TIMI3 flow pattern B) TIMI2 flow pattern C) TIMI 0-1 flow pattern. Demographic, homodynamic, and in hospital and 6 months follow up variables where analyzed. Results: Of the 483 patients included, 363 had TIMI3 flow (group A) 77.73%, 67 patients had TIMI2 flow (group B) 14.34%, 37 patients had TIMI 0-1 flow (group C) 7.92%. There were differences in the incidence of cardiogenic shock, which was present in 11% of patients in group A, 32% of patients in group B, and it was present in 40% of patients in group C (p = 0.0001). There were also differences in the time of onset of symptoms and the start of the PCI, with an average time of onset of symptoms to PCI of 354 min for group A, 404 min for group B, and 567 min. group C. Rescue PCI was performed in 4.6% group A, 5.9% group B and in 16.2% of patients in group C (p = 0.0002). Stent was use in 47.6% of patients in group A, 35.7% in group B and 16.21% in group C. Mortality in the Catheterization Lab. Was seen in 0.55% of patients in group A, in 4.47% of patients in group B and 13.5% in group C. Intrahospitalary death was present in 8.8% group A, 28.35% group B and 51.35% group C, at six months mortality was present in 12.6% in group A, 31.3% in group B and 54% in group C. Conclusion: It is consider that those patients with pattern of coronary TIMI 3 flow after a myocardial infarction have the lowest mortality at short an medium follow up, as is described in world literature.

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