Regular paperImpact of spontaneous anterograde flow of the infarct artery on left ventricular function in patients with a first anterior wall acute myocardial infarction
Section snippets
Study patients:
Six hundred fifty-six consecutive patients with a first anterior wall AMI underwent coronary angiography within 12 hours after the onset of chest pain in Hiroshima City Hospital. There were 143 patients (22%) with initial TIMI 2 or 3 flow on the first angiogram. Of these 656 patients, 478 patients left the catheterization laboratory with TIMI 3 flow. This study consisted of these 478 patients with a first anterior wall AMI in whom coronary angiography was performed within 12 hours after the
Baseline characteristics:
There was no significant difference in baseline clinical and angiographic variables between patients with and patients without spontaneous anterograde flow of the infarct artery except for less collateral circulation in patients with spontaneous anterograde flow (Table 1). Coronary angioplasty was performed less frequently in patients with spontaneous anterograde flow. The baseline characteristics of patients with initial TIMI 2 flow and patients with initial TIMI 3 flow are listed in Table 2,
Discussion
It has been reported that spontaneous anterograde flow to the infarct area assessed before reperfusion therapy is associated with not only a larger improvement of LVEF after reperfusion but also a higher LVEF during the acute phase of AMI.9, 10, 11 Recently, Stone et al10 reported that patients with initial TIMI 3 flow before reperfusion therapy had higher acute LVEF than patients without. In the present study, initial TIMI 3 flow was associated with higher acute LVEF, but the acute LVEF of
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