International Journal of Gerontology
Volume 1, Issue 3 , Pages 125-130, September 2007

Thrombolysis in Myocardial Infarction Frame Count in Single-Vessel Disease After Angioplasty

  • Chih-Hsuan Yen

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Hung-I Yeh

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Hung-I Yeh, Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, 92, Section 2, Chung-San North Road, Taipei 104, Taiwan
    • ,
  • Charles Jia-Yin Hou

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Yu-San Chou

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
    • ,
  • Cheng-Ho Tsai

      Affiliations

    • Section of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan

Accepted 1 August 2007.

Article Outline

SUMMARY 

Background

We compared the thrombolysis in myocardial infarction (TIMI) frame count and examined the impact of angioplasty on the count between patients with normal coronary angiograms and those with single-vessel disease (SVD).

Methods

In 780 consecutive patients referred for coronary angiography, TIMI frame count was measured for 149 patients who had SVD and 32 patients with normal angiograms who underwent the procedure for electro-physiologic study or valvular heart disease survey.

Results

Comparison of each of the three vessels in the normal vessel group with the corresponding non-stenotic vessels in the SVD group showed similar counts in each of the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). For the stenotic vessels, after successful angioplasty, the counts were all reduced (LAD, 54.5 ±28.8 vs. 34.0 ±19.3; LCX, 67.3 ±31.1 vs. 34.1 ±19.0; RCA, 33.2 ±28.1 vs. 19.3 ±7.9; all p <0.05). In addition, the count in the RCA after angioplasty was lower, compared with the RCA of the normal group (19.3 ±7.9 vs. 29.1 ±14.6, p = 0.001). Multivariate analysis showed that the use of oral calcium channel blockers was the only independent predictor for the reduction in RCA after angioplasty.

Conclusion

In patients with SVD, the data of TIMI frame count in the nonstenotic vessels were similar to those without the disease, suggesting that the count in the normal artery is not affected by the adjacent stenotic artery. For the stenotic vessels, angioplasty had differential effects on each of the three arteries, indicating the existence of distinct properties, which is affected by calcium channel blockers, for individual coronary arteries in response to atherosclerosis and/or angioplasty.

Key Words:  angioplasty , coronary artery disease , TIMI frame count

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References 

  1. Gibson CM , Cannon CP , Daley WL , Dodge JT , Alexander B , Marble SJ , et al.   TIMI frame count: a quantitative method of assessing coronary artery flow . Circulation . 1996;93:879–888
  2. 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
  3. Gibson CM , Cannon CP , Greene RM , Sequeira RF , Margorien RD , Leya F , et al.   Rescue angioplasty in the thrombolysis in myocardial infarction (TIMI) 4 trial . Am J Cardiol . 1997;80:21–26
  4. Gibson CM , Rizzo M , McLean C , Dotani I , Goel M , Ryan K , et al.   The TIMI frame count and restenosis: faster is better . J Am Coll Cardiol . 1997;29:201A
  5. Faile BA , Guzzo JA , Tate DA , Nichols TC , Smith SC , Dehmer GJ . Effect of sex, hemodynamics, body size, and other clinical variables on the corrected thrombolysis in myocardial infarction frame count used as an assessment of coronary blood flow . Am Heart J . 2000;140:308–314
  6. Abaci A , Oguzhan A , Eryol NK , Ergin A . Effect of potential confounding factors on the thrombolysis in myocardial infarction (TIMI) trial frame count and its reproducibility . Circulation . 1999;100:2219–2223
  7. Hang CL , Wang CP , Yip HK , Yang CH , Guo BF , Wu CJ , et al.   Early administration of intracoronary verapamil improves myocardial perfusion during percutaneous coronary interventions for acute myocardial infarction . Chest . 2005;128:2593–2598
  8. Gerald SW , Klaus L , Helmuth K , Hans RF . Intracoronary verapamil for reversal of no-reflow during coronary angioplasty for acute myocardial infarction . Catheter Cardiovasc Interv . 2002;57:444–451
  9. Beltrame JF , Turner SP , Leslie SL , Solomon P , Freedman SB , Horowitz JD . The angiographic and clinical benefits of mibefradil in the coronary slow flow phenomenon . J Am Coll Cardiol . 2004;44:57–62
  10. Manginas A , Gatzov P , Chasikidis C , Voudris V , Pavlides G , Cokkinos DV . Estimation of coronary flow reserve using the Thrombolysis In Myocardial Infarction (TIMI) frame count method . Am J Cardiol . 1999;83:1562–1565
  11. Tanedo JS , Kelly RF , Marquez M , Burns DE , Klein LW , Costanzo MR , et al.   Assessing coronary blood flow dynamics with the TIMI frame count method: comparison with simultaneous intracoronary Doppler and ultrasound . Catheter Cardiovasc Interv . 2001;53:459–463
  12. Ohara Y , Hiasa Y , Takahashi T , Yamaguchi K , Ogura R , Ogata T , et al.   Relation between the TIMI frame count and the degree of microvascular injury after primary coronary angioplasty in patients with acute anterior myocardial infarction . Heart . 2005;91:64–67
  13. Chugh SK , Koppel J , Scott M , Shewchuk L , Goodhart D , Bonan R , et al.   Coronary flow velocity reserve does not correlate with TIMI frame count in patients undergoing non-emergency percutaneous coronary intervention . J Am Coll Cardiol . 2004;44:778–782
  14. Stankovic G , Manginas A , Voudris V , Pavlides G , Athanassopoulos G , Ostojic M , et al.   Prediction of restenosis after coronary angioplasty by use of a new index: TIMI frame count/minimal luminal diameter ratio . Circulation . 2000;101:962–968

PII: S1873-9598(08)70033-4

doi:10.1016/S1873-9598(08)70033-4

International Journal of Gerontology
Volume 1, Issue 3 , Pages 125-130, September 2007

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