Both Culprit and Non-Culprit Flow are Abnormal in Acute MI

1. Both Culprit and Non-Culprit Flow are Abnormal in Acute MI Even PTCA of the culprit artery residual stenosis restoresflow only to that observed in the non-culprit (30 frames) and not to normal flow (21 frames) The difference between culprit & non-culprit flow is only 6 frames; the difference between non-culprit and normal flow is 9 frames 36.8 + 22.3 6 frames 30.6 + 13.4 30.6 + 14.6 9 frames 21.0 + 3.1 n =1,322 n = 232 n =1,589 n = 78 In 25% of cases, flow is slower in the non-culprit than culprit In 33% of cases, flow is abnormal following stent placement Gibson et al, JACC 1999; 34: 974-82

2. Comparison of the Global Corrected TIMI Frame Counts in Patients with and Without Adverse Outcomes p=0.02 p=0.06 p=0.009 p=0.01 p=0.002 49.7 + 18.4 47.9 + 23.2 46.9 + 20.4 42.9 + 18.3 41.2 + 16.6 38.6 + 16.7 39.0 + 17.1 39.0 + 17.3 37.3 + 16.1 36.7 + 16.5 Absent Present Absent Present Absent Present Absent Present Absent Present (n=963) (n=42) (n=654) (n=22) (n=619) (n=20) (n=504) (n=98) (n=331) (n=108) Death MI Shock EF<40% Any Event Gibson et al, JACC 1999; 34: 974-82