Pre-Procedural Thrombolysis in Myocardial Infarction Flow in Patients with ST-Segment Elevation Myocardial Infarction

• Published in: International heart journal Vol. 59; no. 5; p. 920
• Main Authors: Hashimoto, Takuya, Ako, Junya, Nakao, Koichi, Ozaki, Yukio, Kimura, Kazuo, Noguchi, Teruo, Yasuda, Satoshi, Suwa, Satoru, Fujimoto, Kazuteru, Nakama, Yasuharu, Morita, Takashi, Shimizu, Wataru, Saito, Yoshihiko, Hirohata, Atsushi, Morita, Yasuhiro, Inoue, Teruo, Okamura, Atsunori, Uematsu, Masaaki, Hirata, Kazuhito, Tanabe, Kengo, Shibata, Yoshisato, Owa, Mafumi, Tsujita, Kenichi, Funayama, Hiroshi, Kokubu, Nobuaki, Kozuma, Ken, Uemura, Shirou, Toubaru, Tetsuya, Saku, Keijirou, Oshima, Shigeru, Nakai, Michikazu, Nishimura, Kunihiro, Miyamoto, Yoshihiro, Ogawa, Hisao, Ishihara, Masaharu
• Format: Journal Article
• Language: English
• Published: Japan 26.09.2018
• Subjects: Infarct-related artery; Antiplatelet drug; Percutaneous coronary intervention; In-hospital clinical outcomes
• ISSN: 1349-3299

It has been shown that the patency of an infarct-related artery (IRA) before primary percutaneous coronary intervention determines post-procedural success, better preservation of left ventricular function, and lower in-hospital mortality. However, the factors associated with pre-procedural Thrombolysis In Myocardial Infarction (TIMI) flow have not been fully investigated.The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective multicenter registry conducted at 28 Japanese medical institutions between July 2012 and March 2014. We enrolled 3,283 consecutive patients with acute myocardial infarction who were admitted to a participating institution within 48 hours of symptom onset. There were 2,262 patients (68.9%) with ST-elevation myocardial infarction (STEMI), among whom 2,182 patients underwent emergent or urgent coronary angiography.Pre-procedural TIMI flow grade 3 was related to post-procedural TIMI flow grade 3 (P < 0.001), lower enzymatic infarct size (P < 0.001), lower ventricular tachycardia and ventricular fibrillation (P = 0.049), and lower in-hospital mortality (P = 0.020). A history of antiplatelet drug use was associated with pre-procedural TIMI flow.Antiplatelet drug use on admission was associated with pre-procedural TIMI flow. The patency of the IRA in patients with STEMI was related to procedural success and decreased enzymatic infarct size, fatal arrhythmic events, and in-hospital mortality.