Relationship between thrombolysis in myocardial infarction risk score and myocardial perfusion in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Gao Yulong
Gong Xiaogang
Tao Ying
Zhang Jingmei
Abstract：Objective To analyze the relationship between thrombolysis in myocardial infarction( TIMI) risk score and myocardial perfusion in patients with ST-segment elevation myocardial infarction(STEMI) undergoing primary percutaneous coronary intervention ( PPCI ) . Methods Clinical data of 882 STEMI patients undergoing PPCI from January to December 2018 in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. The patients were divided into 3 groups according to TIMI risk score: low risk group ( TIMI risk score 0-3, 380 cases), moderate risk group(TIMI risk score 4-6, 424 cases) and high risk group(TIMI risk score≥7, 78 cases) . Baseline data, coronary angiography, PPCI procedure and myocardial perfusion were recorded and the influencing factors of myocardial perfusion were analyzed. Results Age, rates of male, diabetes and hypertension increased among low, moderate and high risk groups(all P<0. 05). Rate of anterior myocardial infarction, heart rate and fasting blood sugar content in high risk group were higher and systolic blood pressure was lower than those in low and moderate risk groups(all P<0. 05). Higher rate of multi-vessel disease was observed with higher TIMI risk score[63. 2％(49/78) for high risk group vs 34. 4％(146/424) for moderate risk group vs 14. 3％(54/380) for low risk group ] ( all P <0. 05 ) . Infarction to reperfusion time was significantly delayed in high risk group compared to moderate and low risk groups[(79 ±27)min vs (63 ±18),(58 ±14)min](both P<0. 05). Rates of myocardial perfusion grade 3 measured by TIMI blood flow, TIMI myocardial perfusion and myocardial blush grade significantly descended in high risk group compared to those in moderate and low risk groups(all P<0. 05). Logistic regression analysis showed that TIMI risk score was an independent predictor of myocardial perfusion following PPCI(odds ratio=4. 987, 95％ confidence interval: 1. 243-7. 516, P=0. 016). Conclusions STEMI patients with high TIMI risk score have poor myocardial perfusion after PPCI. Early identification of high risk patients and timely restoring of smooth blood flow can improve myocardial perfusion and the progress.
Keywords：ST-segment elevation myocardial infarctionPrimary percutaneous coronary interventionThrombolysis in myocarolial infarction risk score
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1470-1473 )