TIMI Risk Score as a Predictor for No-Reflow Phenomenon in Patients Undergoing Primary Angioplasty for Acute STEMI
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- Category: Vol. 85, June 2017
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TIMI Risk Score as a Predictor for No-Reflow Phenomenon in Patients Undergoing Primary Angioplasty for Acute STEMI, IBRAHIM MAHMOUD, MOHAMED HOSNY, MOHAMED FAWZY, DALIA RAGAB and HATEM EL-ATROUSH
Abstract
Objectives: It has been well documented that patients presented with acute ST segment Elevation Myocardial Inf-arction (STEMI) treated with primary Percutaneous Coronary Angiography (PCI) with angiographic no-reflow phenomenon have higher incidence of both in hospital and long term MACE. Early detection and proper follow-up of these patients may improve the long term survival. Our study was proposed to evaluate the value of TIMI risk score of STEMI as a predictor of no-reflow phenomenon after primary PCI.
Patients and Methods: We analyzed 760 patients presented with acute STEMI and underwent primary PCI within 24 hours of symptoms onset, we divided the patients into no-reflow group (TIMI flow post PCI £2) and normal flow group (TIMI flow post PCI=3).
Results: TIMI risk score was significantly higher in the no-reflow group compared to the normal flow group (10.1±2.3 vs. 5.6±1.3, p<0.001), the predictive value of the TIMI score for no reflow was 0.78 (p<0.001). After application of multi-variate regression analysis, TIMI risk score of STEMI was an independent predictors of no-reflow phenomenon odds ratio (HR 5.208, 95% CI 1.466-18.495, p<0.011). TIMI risk score showed cut-off 6.5 with AUC 96.1%, p-value <.001 with sensitivity of 96.1% and specificity of 74.1%.
Conclusion: Admission TIMI risk score of STEMI patients can predict angiographic no-reflow phenomenon after primary PCI.