The utility of the TIMI risk index on admission for predicting angiographic no-reflow after primary percutaneous coronary intervention in patients with STEMI

Abstract

Background/aim: The thrombolysis in myocardial infarction (TIMI) risk score (TRS), and the TIMI risk index (TRI) have been reported in coronary artery disease patients. We investigated whether admission TRI is associated with no-reflow (NRF) in patients undergoing primary percutaneous coronary intervention (p-PCI).Materials and methods: ST-segment elevation myocardial infarction (STEMI) patients treated with p-PCI were included in the study. TRI was calculated on admission using specified variables. We defined the angiographic NRF phenomenon as a coronary TIMI flow grade of ≤2 after the vessel was recanalized or a TIMI flow grade of 3 together with a final myocardial blush grade (MBG) of <2 in a manner as described in previous studies.Results: A total of 371 patients (aged 62 ± 14 years; 73/27 men to women ratio) who underwent p-PCI were enrolled in the study. In terms of age, NRF patients were older than reflow patients (P < 0.017 for MBG). Killip class III-IV designations were more common in NRF patients (P = 0.029 for MBG). TRI (P = 0.014 for MBG) values were significantly greater in the NRF group. TRI was an independent predictor of NRF according to MBG flow (P = 0.003, B = -0.035, Exp B = 0966, 95% CI, 0.944-0.988). Conclusion:Admission TRI may predict the development of NRF phenomenon after p-PCI in patients with acute STEMI.

The relationship between homocysteine and no-reflow phenomenon in patients undergoing primary percutaneous coronary intervention

“…In a similar line to a past study, our findings demonstrated a significant relationship between TIMI risk score and no-reflow. 27 Of note, we found the TIMI risk score as an independent predictor of no-reflow. TIMI risk score includes clinical variables like age, diabetes mellitus/ hypertension/angina, blood pressure, heart rate, Killip class, weight, anterior ST-elevation or left bundle branch block, and time to treatment.…”

The ATRIA and Modified-ATRIA Scores in Evaluating the Risk of No-Reflow in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention

“…The TIMI risk score used to evaluate the in-hospital prognosis in patients with STEMI, the TIMI risk index, which Acet et al 40 showed can predict angiographic NR and the score devised by Bayramoğlu and colleagues, 41 consisting of 7 parameters, are some of the scoring methods that can be used for NR. There are studies supporting the relationship between NR and the CHA 2 DS 2 -Vasc score, which is among these risk scores and is considered to be a prognostic marker for many cardiac conditions.…”

LncRNA MALAT1 functions as a biomarker of no-reflow phenomenon in ST-segment elevation myocardial infarction patients receiving primary percutaneous coronary intervention

“…ET-1 also plays an important role in endothelial inflammation and the formation of atherosclerotic plaques 18 . Additionally, the network structure of stents can aggravate microcirculation dysfunction to induce chemotaxis and trigger monocyte activation to secrete various vasoactive factors like ET-1 and VCAM-1, which in turn induce the onset of reperfusion injury 19 , 20 .…”