![]() Over the years there has been marked advancement in the management of patients presenting with STEMI in the areas of pre-hospital management, pharmacological therapy and procedural techniques. Preprocedural TIMI flow has been found to be an independent predictor of survival in patients with acute myocardial infarction, and has also been shown to predict final infarct size. Previous studies have demonstrated that patients with low grade TIMI flow prior to percutaneous coronary intervention (PCI) have a less favorable outcome. TIMI flow grade 0 represents total occlusion, while TIMI flow grade 3 represents normal epicardial perfusion. Thrombolysis in Myocardial Infarction (TIMI) coronary grade flow is an established, validated score to assess the epicardial perfusion on coronary angiography. Nevertheless, over time, in-hospital complications have decreased among patients with TIMI 0, while 30d MACE and 1-year mortality has remained unchanged. TIMI flow grade 0 is still more common among patients with STEMI and is associated with poorer prognosis. There was no temporal change of these outcomes in either TIMI flow grade group. Compared with TIMI flow 1–3, patients with TIMI flow 0 had worse 30d MACE and 1-year mortality. In-hospital complications of patients with TIMI flow 0 has significantly decreased over time (36.1% vs 26.8%, P < 0.001) but not amongst patients with TIMI flow 1–3. The majority of patients had pre-procedural TIMI flow 0 (58.9% in the early period and 58.7% in the late period, P = 0.97). Results and Conclusions: Included were 2453 patients. Clinical outcomes included in-hospital complications, 30d MACE (death, myocardial infarction, stroke, unstable angina, stent thrombosis, urgent revascularization) and 1-year mortality. Survey years were divided to early (2008–2010) and late period (2013–2018). A time-dependent analysis stratifying patient by TIMI flow grade 0 and TIMI flow grade 1–3 was performed. High risk patients received thrombolytic less frequently than the patients at low risk.Data of patients with STEMI from the acute coronary syndrome Israeli Survey (ACSIS) registry. There was a progressive increase in mortality and incidence of in-hospital complications according to the stratification by the TIMI score. The chance of receiving fibrinolytic was 50% lower in the high-risk group in relation to the low risk group (95% CI = 0.27 to 0.85, p = 0.004). The risk of death in cases of high risk was 14.1 times higher than in the cases of medium and low risk (95% CI = 4.4 to 44.1 and p <0.001). The mortality was 8.1% in the medium risk group and 55.6% in the high-risk group. In the low-risk group there was no death. The hospital mortality after infarction was 17.5%. The cases were analyzed in three risk groups according to the TIMI score. We evaluated, retrospectively, 103 cases of acute myocardial infarction with ST-segment elevation admitted to the Hospital Nossa Senhora da Conceição - Tubarão, in 20. To evaluate the management and clinical evolution of hospital inpatients with acute myocardial infarction, according to risk stratification by the TIMI score. As the risk profiles of these cases differ from those found in non-selected populations, it is important to review the applicability of the score in usual clinical conditions. The TIMI (Thrombolysis in Myocardial Infarction) risk score is derived from clinical trial involving patients who are eligible for fibrinolysis. ![]()
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