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Updated: Aug 6, 2026
Dynamic Assessments of Coronary Flow Reserve after Myocardial Ischemia Reperfusion in Mice
Published on: August 25, 2023
Association of reperfusion delay with inflammatory markers and coronary flow impairment assessed by corrected TIMI
Reza Arian Nia1, Morteza Safi1, Mohammad Saeed Soleimani Meigoli2
1Cardiovascular Research Center, Modarres Hospital, Shahid Beheshti University of Medical Sciences Tehran, Iran.
Insights
Delayed reperfusion in ST-segment elevation myocardial infarction (STEMI) is linked to higher inflammation and worse coronary microvascular function. Minimizing treatment delays is crucial for improving outcomes in STEMI patients.
Area of Science:
- Cardiology
- Biomedical Science
- Inflammation Research
Background:
- Timely reperfusion is critical for ST-segment elevation myocardial infarction (STEMI) management.
- Reperfusion delays can worsen systemic inflammation and impair coronary microvascular flow.
- This study investigates the link between reperfusion timing, inflammation, and coronary flow in STEMI patients.
Purpose of the Study:
- To examine the association between reperfusion delay and inflammatory markers (ESR, CRP) at admission.
- To assess the relationship between reperfusion delay and impaired coronary microvascular flow (CTFC).
- To understand the impact of reperfusion timing on inflammatory response and coronary flow in STEMI patients undergoing primary PCI.
Main Methods:
- A single-center observational cohort study of 104 STEMI patients undergoing primary PCI.
- Reperfusion delay categorized by symptom-to-balloon time (<2, 2-4, 4-6, >6 hours).
- Measured admission and post-PPCI inflammatory markers (ESR, CRP) and coronary flow (CTFC).
Main Results:
- Coronary flow (CTFC) worsened progressively with longer reperfusion delays (P < 0.05).
- Admission ESR and CRP levels were significantly higher with increased symptom-to-balloon time (P < 0.05).
- Elevated admission ESR and CRP correlated with increased CTFC, indicating impaired flow.
Conclusions:
- Delayed reperfusion in STEMI patients is associated with a higher inflammatory burden and impaired coronary microvascular function.
- Inflammatory activation during prolonged ischemia may contribute to poor coronary flow.
- Minimizing reperfusion delay is essential for improving outcomes in STEMI patients.
Background:
Timely reperfusion remains central to the management of ST-segment elevation myocardial infarction (STEMI). In addition to limiting infarct size, delays in reperfusion may intensify systemic inflammation and contribute to impaired coronary microvascular flow, even when epicardial recanalization appears angiographically successful. This study examined whether reperfusion delay is associated with inflammatory markers at admission and impaired coronary flow measured by corrected TIMI frame count (CTFC) in patients with STEMI treated with primary PCI.
Methods:
We conducted a single-center observational cohort study including 104 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (PPCI).Reperfusion delay was defined as symptom-to-balloon time and was grouped into four categories (< 2, 2-4, 4-6, and > 6 hours). Inflammatory markers, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), were measured at admission and after PPCI. Coronary flow was quantitatively assessed using the corrected TIMI frame count (CTFC). Associations between reperfusion delay, inflammatory markers, and CTFC were evaluated.
Results:
CTFC values increased progressively with longer reperfusion delay, indicating worsening coronary flow (P < 0.05). Admission ESR increased significantly with longer symptom-to-balloon time (P < 0.05), and higher CRP categories were more frequently observed among patients with delayed reperfusion (P < 0.05). Higher ESR and CRP levels at admission were also associated with increased CTFC values. Post-procedural ESR and CRP levels, however, showed no significant association with reperfusion delay or CTFC (P > 0.05). Higher ESR and CRP levels at admission were also linked with increased CTFC values. Post-procedural ESR and CRP levels, however, showed no significant association with reperfusion delay or CTFC.
Conclusions:
In patients with STEMI undergoing primary PCI, delayed reperfusion is associated with increased inflammatory burden at presentation and impaired coronary flow as assessed by corrected TIMI frame count. Taken together, these findings suggest that inflammatory activation during prolonged ischemia may contribute to impaired coronary flow and highlight the continued importance of minimizing reperfusion delay.
