The purpose of the study was to determine the prognostic value of simultaneous evaluation of angiographic (TIMI flow) and ECG (ST segment resolution) changes on hospital results in primary percutaneous transluminal coronary angioplasty patients.
Methods and patients: The primary percutaneous transluminal coronary angioplasty was performed in 250 patients with the first acute myocardial infarction. All the patient were divided into four groups according the restored TIMI flow and the resolution of ST segment changes. Group A (44 pts) - TIMI<or=2, ST resolution <50%, group B (13 pts) - TIMI<or=2, ST resolution >or=50%, group C (99 pts) - TIMI>2, ST resolution <50%, and group D (94 pts) - TIMI>2, ST resolution >or=50%.
Results: The study has revealed that in hospital mortality was 15.9%, 6.1% and 1.1% in group A, group C and group D, respectively. The higher proportion of patients with not adequate sufficient myocardial perfusion (less complete ST segment resolution) had myocardial infarction in left anterior descending artery region. The higher proportion of patients with adequate myocardial perfusion had no atherosclerotic injury in coronary arteries except infarct related artery.
Conclusion: The achieving of TIMI flow grade 3 and perfect resolution of ST segment elevation after primary percutaneous transluminal coronary angioplasty has beneficial effect on in - hospital mortality. The effective restoration of flow in infarct related artery not always accompanies full and rapid ST segment normalization suggesting the presence of incomplete myocardial perfusion.