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Correlation Between Corrected TIMI Frame Count with the Extent of Myocardial Fibrosis on ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Diponegoro, Indonesia

2Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Indonesia

3Dr. Sardjito General Hospital, Indonesia

Received: 15 Nov 2023; Accepted: 29 Apr 2024; Available online: 30 Apr 2024; Published: 30 Apr 2024.
Open Access Copyright (c) 2024 Journal of Biomedicine and Translational Research
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Background: Microvascular injury after primary percutaneous coronary intervention (PPCI) reperfusion contributes to necrosis propagation. Corrected TIMI Frame Count (CTFC) is a surrogate marker of microvascular dysfunction and can stratify in-hospital mortality risk in patients with final TIMI flow 3. The extent of myocardial fibrosis after STEMI is associated with a higher incidence of major cardiovascular events. This study aimed to determine the relationship between CTFC in the infarct-related artery and myocardial fibrosis area based on cardiac magnetic resonance (CMR) in STEMI patients undergoing PPCI.

Methods: This retrospective cohort study included 31 STEMI patients who had undergone PPCI and CMR examination between days 60 and 75 after STEMI as the sample. CTFC was measured in the infarct-related artery from post-PPCI angiogram recordings. Myocardial fibrosis area was measured from late gadolinium enhancement CMR (LGE-CMR) imaging results.

Results: In this study, the mean age was 51.61±10.49 years, 90.3% were male, non-anterior infarction location was 58.1%, mean total ischemic time was 489.48±228.33 minutes, mean CTFC was 27.4±9.3 frames, and mean myocardial fibrosis was 18.33±7.87%. There was no significant correlation found between CTFC and myocardial fibrosis (p=0.530), however total ischemic time had a positive and significant correlation with myocardial fibrosis (p=0.025, r=0.403).

Conclusion: CTFC in the infarct-related artery is not correlated with myocardial fibrosis area in STEMI patients undergoing PCI.

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Keywords: CTFC; myocardial fibrosis; LGE-CMR; STEMI; PPCI

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  1. Abbafati C, Abbas KM, Abbasi-Kangevari M, Abd-Allah F, Abdelalim A, Abdollahi M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396: 1204–1222. DOI: 10.1016/S0140-6736(20)30925-9
  2. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevationThe Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2018; 39: 119–177. DOI: 10.1093/eurheartj/ehx393
  3. The GUSTO Investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med 1993; 329: 673–682. DOI: 10.1056/NEJM199309023291001
  4. Eitel I, de Waha S, Wöhrle J, Fuernau G, Lurz P, Pauschinger M, et al. Comprehensive Prognosis Assessment by CMR Imaging After ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol 2014; 64: 1217–1226. DOI: 10.1016/j.jacc.2014.06.1194
  5. Gibson CM, Murphy SA, Rizzo MJ, Ryan KA, Marble SJ, McCabe CH, et al. Relationship Between TIMI Frame Count and Clinical Outcomes After Thrombolytic Administration. Circulation 1999; 99: 1945–1950. DOI: 10.1161/01.cir.99.15.1945
  6. Hamada S, Nishiue T, Nakamura S, Sugiura T, Kamihata H, Miyoshi H, et al. TIMI frame count immediately after primary coronary angioplasty as a predictor of functional recovery in patients with TIMI 3 reperfused acute myocardial infarction. J Am Coll Cardiol 2001; 38: 666–671. DOI: 10.1016/s0735-1097(01)01424-3
  7. Heymans S, González A, Pizard A, Papageorgiou AP, López-Andrés N, Jaisser F, et al. Searching for new mechanisms of myocardial fibrosis with diagnostic and/or therapeutic potential. Eur J Heart Fail 2015; 17: 764–771. DOI: 10.1002/ejhf.312
  8. Piek A, de Boer RA, Silljé HHW. The fibrosis-cell death axis in heart failure. Heart Fail Rev 2016; 21: 199–211. DOI: 10.1007/s10741-016-9536-9
  9. Stone GW, Selker HP, Thiele H, Patel MR, Udelson JE, Ohman EM, et al. Relationship Between Infarct Size and Outcomes Following Primary PCI: Patient-Level Analysis From 10 Randomized Trials. J Am Coll Cardiol 2016; 67: 1674–1683. DOI: 10.1016/j.jacc.2016.01.069
  10. De Luca G, Suryapranata H, de Boer MJ, Ottervanger JP, Hoorntje JCA, Gosselink ATM, et al. Combination of electrocardiographic and angiographic markers of reperfusion in the prediction of infarct size in patients with ST-segment elevation myocardial infarction undergoing successful primary angioplasty. Int J Cardiol 2007; 117: 232–237. DOI: 10.1016/j.ijcard.2006.04.082
  11. Aydin S, Ugur K, Aydin S, Sahin İ, Yardim M. Biomarkers in acute myocardial infarction: Current perspectives. Vasc Health Risk Manag 2019; 15: 1–10. DOI: 10.2147/VHRM.S166157
  12. Cabaniss CD. Creatine Kinase. In: Walker HK, Hall WD, Hurst JW (eds). Boston, 1990. PMID: 21250193
  13. Rosenblat J, Zhang A, Fear T. Biomarkers of myocardial infarction : past, present and future. Univ West Ont Med J 2012; 81: 23–25
  14. Tilea I, Varga A, Serban RC. Past, present, and future of blood biomarkers for the diagnosis of acute myocardial infarction—promises and challenges. Diagnostics 2021; 11: 1–19. DOI: 10.3390/diagnostics11050881
  15. Dai Z, Aoki T, Fukumoto Y, Shimokawa H. Coronary perivascular fibrosis is associated with impairment of coronary blood flow in patients with non-ischemic heart failure. J Cardiol 2012; 60: 416–421. DOI: 10.1016/j.jjcc.2012.06.009
  16. Reimer KA, Lowe JE, Rasmussen MM, Jennings RB. The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation 1977; 56: 786–794. DOI: 10.1161/01.cir.56.5.786
  17. JENNINGS RB, SOMMERS HM, SMYTH GA, FLACK HA, LINN H. Myocardial necrosis induced by temporary occlusion of a coronary artery in the dog. Arch Pathol 1960; 70: 68–78. PMID: 14407094

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