الفهرس 
Acute myocardial infarctionOnly 14 pages are availabe for public view
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Abstract
Aim: Primary percutaneous coronary intervention (PCI) is the preferred treatment in STEMI. However, the prognostic role of spontaneous re-canalization in these patients is still not clear. The importance of early reperfusion is clearly supported by the larger extension of myocardial necrosis observed with poor pre-procedural TIMI flow. The purpose of this study is to evaluate the impact of pre-procedural TIMI flow grade in the culprit coronary artery on the short and long term prognosis in Egyptian patients presented with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI.
Methods and results: A dual center, prospective observational study that was conducted in the period from January 2019 till June 2020 and enrolled 150 STEMI patients presented within 24 hours from onset of chest pain. Initial angiography was done with analysis of TIMI flow grade in the infarct related artery. Of the 150 enrolled patients; 93 patients (62%) were found to have initial TIMI flow grade 0 (group A) and 57 patients (38%) had initial TIMI flow grade I-III (group B). There was a strong association between cardiac mortality and pre TIMI flow grade. 12 mortalities (8% of total study population) were recorded during our study period; in-hospital mortality was reported in 7 patients in group A, yet no mortalities were recorded in-hospital in group B (p-value= 0.033). At one year follow up; 5 mortalities were recorded in group A with no mortalities at all in group B. (p-value =0.005).
Conclusion: Despite the evolution in primary PCI strategies and the continuous advancement in anti-thrombotic treatment; pre-interventional infarct related artery TIMI flow grade I-III is associated with better in hospital and 1 year outcome, specifically significantly lower cardiac mortality compared to patients who had TIMI flow grade 0 at initial angiography.