![]() Patients with TIMI grade 3 flow had, in general, higher risk features than those with TIMI grade 0 to 2 flow, except for a lower rate of ST-segment elevation. The baseline characteristics of the 2 groups are listed in Table 1. At baseline angiography, TIMI grade 3 flow in the IRA was present in 932 patients (17.5%), while TIMI grade 0 to 2 flow was present in 4,400 patients (82.5%), including 733 (16.7%) with TIMI grade 2 flow and 3,667 (83.5%) with TIMI grade 0 or 1 flow. ST-segment elevation or left bundle branch blockĬore laboratory angiographic data were evaluated in 5,332 patients in whom PCI was performed in CADILLAC (n = 2,051) and HORIZONS-AMI (n = 3,281). All analyses were performed using SAS version 9.2 (Cary, North Carolina). A p value <0.05 was considered statistically significant. The multivariate model for cardiac mortality included only the following variables known or presumed to influence outcome: baseline TIMI grade 0 to 2 flow, final TIMI grade 0 to 2 flow, creatinine clearance ≤60 ml/min/1.73 m 2, age, diabetes, body mass index, the left ventricular ejection fraction, Killip class 2 to 4 heart failure, history of congestive heart failure, LAD versus non-LAD IRA, and number of diseased vessels. Cox proportional-hazards multivariate regression analysis was performed to identify whether baseline TIMI grade 3 flow was an independent predictor of 1-year total (n = 187) and cardiac (n = 119) mortality, using the variables listed in Tables 1 to 3, first without including final TIMI flow and then adding it to the model. The left ventricular ejection fraction was not considered, because of a lack of data in a nearly 25% of patients. Patients with compared to those without baseline TIMI grade 3 flow had significantly higher rates of post-PCI TIMI grade 3 flow (99.1% vs 91.4%, p 60 ml/min/1.73 m 2. The independent predictors of baseline TIMI grade 3 flow were diabetes, longer delay to PCI, smoking, and more extensive coronary disease. Baseline TIMI grade 3 flow was present in 932 of 5,332 patients (17.5%). The Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) and Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trials were combined, and the predictors of core laboratory–determined baseline TIMI grade 3 flow and 1-year outcomes were analyzed according to baseline TIMI flow. The aim of this study was to identify the predictors and implications of spontaneous reperfusion before primary PCI in patients with ST-segment elevation myocardial infarction. Yet pharmacologic strategies increasing the rates of pre-PCI TIMI grade 3 flow resulted in more bleeding, without a benefit in survival. Pre–percutaneous coronary intervention (PCI) Thrombolysis In Myocardial Infarction (TIMI) grade 3 flow has been identified as a predictor of final TIMI grade 3 flow and better survival. ![]()
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