• Clotilde Bailleul, Nadia Aissaoui, Guillaume Cayla, Jean-Guillaume Dillinger, Bernard Jouve, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin, Etienne Puymirat, and FAST-MI investigators.
• Department of cardiology, université Paris-Descartes, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France.
• Arch Cardiovasc Dis. 2018 Feb 1; 111 (2): 101-108.

BackgroundThrombolysis in myocardial infarction (TIMI) flow grade 2 or 3 before percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) is associated with improved outcomes. However, no recent data are available on its impact beyond 1 year and/or by type of AMI.AimsTo assess the prognostic impact of prePCI TIMI flow at 30 days and 3 years in patients with ST-segment elevation (STEMI) or non-ST-segment elevation (NSTEMI) AMI.MethodsWe compared long-term outcomes associated with TIMI flow grade 2/3 versus 0/1 in patients referred for PCI in the nationwide French registry of acute ST-segment elevation or non-ST-segment elevation myocardial infarction (FAST-MI) 2010.ResultsTIMI flow grade 2/3 was found in 41% of patients with STEMI and 69% of patients with NSTEMI; it was associated with a lower risk of 30-day death in patients with STEMI (odds ratio 0.30, 95% confidence interval [CI] 0.12-0.77; P=0.01), but not in patients with NSTEMI (odds ratio 0.57, 95% CI 0.22-1.42; P=0.23). TIMI grade flow 2/3 was also associated with a lower risk of 3-year death in patients with STEMI (hazard ratio 0.69, 95% CI 0.49-0.98; P=0.04), but not in patients with NSTEMI (hazard ratio 0.79, 95% CI 0.56-1.11; P=0.17).ConclusionTIMI flow grade 2/3 is observed more often in patients with NSTEMI; it is an independent predictor of early and late survival in patients with STEMI, but is not significantly related to early or long-term survival in patients with NSTEMI.Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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