The relationship between renal functions and thrombolysis in myocardial infarction frame count in patients with slow coronary flow
ABSTRACT We investigated the relationship between renal function and coronary thrombolysis in myocardial infarction frame count (TFC) in patients with slow coronary flow (SCF). The patient group was composed of 34 patients with SCF. The control group was made up of 34 well-matched individuals who have normal SCF in their coronary arteries. The coronary flow rates of all subjects were documented by TFC. Glomerular filtration rate (GFR) and corrected GFR (cGFR) were calculated by creatinine clearance according to the Cockcroft-Gault formula. There is no difference in the gender or age of the groups. Blood urea nitrogen and creatinine were significantly higher in the SCF group compared the control group (blood urea nitrogen: 17 ± 6 mg/dL vs. 14 ± 4 mg/dL, p=0.04 and creatine: 0.9 ± 0.1mg/dL vs. 0.7 ± 0.1mg/dL, p=0.01). GFR and cGFR were significantly different between the groups (GFR: 92 ± 28 mL/min vs. 112 ± 27 mL/min, p=0.004 and cGFR: 77 ± 22 mL/min/1.73 m(2)vs. 96 ± 24 mL/min/1.73 m(2), p=0.007). There was a negative correlation between GFR/cGFR and TFC in all coronary arteries. This study shows that impaired renal function is associated with SCF. Patients with SCF have worse renal function compared with patients without SCF.
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ABSTRACT: No reflow following primary percutaneous coronary intervention (PCI) is a serious complication in the treatment of acute myocardial infarction. No reflow in some patients is reversible (transient no reflow), whereas no reflow in others persists until the end of the procedure (persistent no reflow). The aim of this study was to identify clinical features of transient no reflow following primary PCI. Consecutive patients with no reflow (n = 123) were enrolled following primary PCI. Among them, 59 patients were in the transient group and 64 in the persistent group. We compared clinical features and hospital outcomes between the two groups. Multivariate logistic regression analysis was performed to identify the determinants of transient no reflow. The transient group had a lower rate of in-hospital cardiac death than the persistent group (0 vs. 6.4 %, relatively, P = 0.018). There was a trend for a shorter length of hospital stay in the transient group. Multivariate logistic regression analysis identified initial thrombolysis in myocardial infarction (TIMI) flow grade 3 (OR 6.239, 95 % CI 1.727-22.541, P = 0.005) and a higher estimated glomerular filtration rate (OR 1.204, 95 % CI 1.006-1.440, P = 0.042) as independent predictors of transient no reflow. Transient no reflow tended to be associated with TIMI thrombus grade ≤3 (OR 2.879, 95 % CI 0.928-8.931, P = 0.067). In conclusion, initial TIMI flow grade 3 and preserved renal function were associated with recovery from no reflow. Initial angiographic finding such as TIMI flow or TIMI thrombus grade might be an important predictor of recovery from the no-reflow phenomenon.Heart and Vessels 06/2013; DOI:10.1007/s00380-013-0379-1 · 2.11 Impact Factor
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ABSTRACT: Background Slow coronary flow (SCF) is defined as late opacification at the epicardial coronary arteries without stenosis, in this study we search the effect of isolated CSF on P-wave and QT-interval dispersion. Patients and methods Thirty five patients with CSF (group 1), and 30 control subjects (group II) matched in sex and age. Both groups underwent a standard 12-lead surface electrocardiogram. Maximal (P max), minimal P-wave durations (P min), P dispersion (PD), and QT dispersion were measured. All patients underwent selective coronary angiography. Coronary flow rates were documented by Thrombolysis in Myocardial Infarction (TIMI) frame count. Results CSF patients had more P maximum, P dispersion, C QT duration, QT dispersion, and C QT dispersion. TIMl frame counts of CSF patients were significantly higher than those of the control group for all three coronary vessels (P 0.0001). PD was positively correlated with LAD TIMI frame count (r = 0.42; P: 0.01); LCx TIMI frame count (r = 0.40; P: 0.01); and mean TIMI frame count (r = 0.44; P: 0.007), while weak correlated with RCA TIMI frame count (r = 0.22; and not statistically significant P: 0.18), C QT dispersion was positively correlated with LAD TIMI frame count (r = 0.54; P: 0.001); LCx TIMI frame count (r = 0.70; P: 0.001); and mean TIMI frame count (r = 0.50; P: 0.002), while weak correlated with RCA TIMI frame count (r = 0.24; and not statistically significant P: 0.15). Conclusion CSF was found to be associated with prolonged dispersion of P-wave and QT-interval.09/2013; 65(3):175–180. DOI:10.1016/j.ehj.2012.08.002