Predictors of TIMI Flow Grade after Primary PCI in Cases of Anterior STEMI: A single Center Study

Background: Primary PCI is considered the preferred reperfusion modality for patients presenting with STEMI, It is possible that differences in technical details of the procedure account for major part of success of primary PCI. Predictors of success is still under investigation.Objectives: To assess the predictors of angiographic success by TIMI flow grade in patients with anterior STEMI managed by primary PCI.Methods: From January 2009 till December 2011, primary PCI was done to 213 cases of anterior STEMI. Risk factors, procedural data and outcomes were analyzed.Results: Mean age was 54.7±10 yrs, 83.7% were males, 76.1 % were smokers, and 51.2% had dyslipidemia. Hypertension affected 50.7% of patients, while DM affected 48.8%. Chest pain duration varied between 5 up to 24h with mean of 6.7±5h. Single vessel disease (LAD) was found in 68.5%, 18.3% had 2 vessel disease, while 13.1% had multivessel disease. Regarding TIMI flow after revascularization, 156 patients achieved TIMI 3 flow (73.2%), 40 patients had TIMI 2 flow (18.8%), 15 patients had TIMI 1 flow (7%), while 2 patients developed TIMI 0 flow (0.9%). Predictors of TIMI flow grade were: DM, symptoms duration, Killip class, thrombus burden, pre-dilatation, total nature of occlusion, patency of infarct-related artery, multivessel CAD and length of deployed stents.Conclusion: Reducing risk factors of coronary artery disease, especially DM, shortening time from symptoms onset till seeking medical advice, avoidance of pre-dilatation if possible are mandatory to achieve TIMI 3 flow.