Determinants and prognostic significance of spontaneous coronary recanalization in acute myocardial infarction

Cheol Whan Lee, Myeong Ki Hong, Jae Hwan Lee, Hyun Suk Yang, Jae Joong Kim, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Spontaneous recanalization (SR) occurs after the onset of acute myocardial infarction (AMI), but its clinical significance in the reperfusion era remains uncertain. We evaluated the determinants and prognostic significance of SR in 196 consecutive patients with AMI who underwent primary angioplasty at our institution. The study population was divided into 2 groups according to the presence (group I, n = 44) or absence (group II, n = 152) of SR (Thrombolysis In Myocardial Infarction [TIMI] anterograde ≥2 flow on the preintervention angiogram). The primary end point was the occurrence, within 6-weeks after AMI, of death, nonfatal reinfarction, and congestive heart failure. Baseline characteristics were similar between the 2 groups. Peak levels of creatine kinase were lower in group I than in group II (2,500 ± 1,800 vs 4,000 ± 2,900 U/L, respectively, p <0.05). The rate of TIMI flow grade 3 after intervention was higher in group I than in group II (93.2% vs 79.6%, respectively, p <0.05), and patients in group I had a faster corrected TIMI frame count than those in group II (22.7 ± 12.4 vs 30.3 ± 22.8, respectively, p <0.05). Preinfarction angina (odds ratio [OR] 2.18, 95% confidence interval [CI] 1.10 to 4.33, p <0.05), heavy thrombi (OR 0.10, 95% CI 0.01 to 0.74, p <0.05), and good angiographic collaterals (OR 0.12, 95% CI 0.02 to 0.89, p <0.05) were independent predictors of SR. Death, reinfarction, and severe arrhythmia were not different between the 2 groups. However, heart failure occurred more frequently in group II than in group I (15.1% vs 2.3%, respectively, p <0.05). The primary end point was also significantly lower in group I than in group II (4.5% vs 18.4%, respectively, p <0.05). In conclusion, SR in AMI is associated with faster coronary flow, smaller infarct size, and a better clinical outcome after primary angioplasty.

Original languageEnglish
Pages (from-to)951-954
Number of pages4
JournalAmerican Journal of Cardiology
Volume87
Issue number8
DOIs
Publication statusPublished - 2001 Apr 15

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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