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A Clinical Score to Predict "Corrected Thrombolysis in Myocardial Infarction Frame Count" in Patients With ST-Segment
Flora Ozkalayci1, Erdem Türkyılmaz2, Ali Karagoz3
1Department of Cardiology, Hisar Intercontinental Hospital, İstanbul, Turkey.
Insights
This study identifies key factors predicting coronary blood flow in myocardial infarction patients before treatment. The findings help clinicians assess individual perfusion risks more accurately.
Area of Science:
- Cardiology
- Medical Imaging
- Biostatistics
Background:
- Coronary blood flow assessment is crucial for cardiovascular outcomes.
- Corrected thrombolysis in myocardial infarction frame count (cTFC) offers an objective measure of epicardial blood flow.
- Identifying predictors of cTFC is essential for personalized patient management.
Purpose of the Study:
- To develop predictive models for epicardial blood flow using cTFC.
- To create a diagnostic tool for individualized assessment of coronary perfusion before primary percutaneous coronary intervention (pPCI).
Main Methods:
- Retrospective analysis of 3205 ST-segment elevation myocardial infarction patients undergoing pPCI.
- Multivariable linear regression to identify predictors of cTFC.
- Development of a nomogram for predicting cTFC based on candidate variables.
Main Results:
- Key predictors of cTFC included age, diabetes mellitus, total ischemic time, systolic blood pressure, heart rate, and prior statin use.
- These factors remained significant in both full and reduced multivariable models.
- The median cTFC was 22 (IQR: 16.5-28.0) in the study cohort.
Conclusions:
- A predictive model incorporating clinical and demographic factors can estimate epicardial blood flow (cTFC).
- This model aids in the individualized assessment of perfusion in STEMI patients undergoing pPCI.
- Clinicians can use this tool to identify patients at higher risk of impaired epicardial perfusion.
Abstract:
Corrected thrombolysis in myocardial infarction frame count (cTFC) is an objective, simple, and reproducible method to assess coronary blood flow which is a surrogate for cardiovascular outcomes. It is important to learn which factors are associated with cTFC. The goal of this study was to determine predictive models for epicardial blood flow assessed by cTFC and develop a diagnostic predictive model that indicates the individualized assessment of epicardial blood flow prior to primary percutaneous coronary intervention. This is a retrospective study including 3205 patients with ST-segment elevation myocardial infarction who underwent pPCI. The primary outcome was cTFC. Multivariable linear regression analysis was performed. Subsequently, a nomogram was developed to predict cTFC according to the candidate predictors. Median age was 58; the number of male patients was 2381 (74.3%). Median value of cTFC was 22 and interquartile range (IQR): 16.5-28.0). Age, diabetes mellitus (DM), total ischemic time, systolic blood pressure (SBP), heart rate (HR), and history of statin use remained in both full and reduced models. Our model may potentially allow clinicians to identify patients at high risk for impaired epicardial perfusion.
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