Relationship between corrected TIMI frame counts at three weeks and late survival after myocardial infarction

OBJECTIVES To evaluate the corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (CTFC) as a predictor of late survival after myocardial infarction. BACKGROUND Thrombolysis in Myocardial Infarction flow grades predict late s urvival after myocardial infarction. The CTFC provides a more reproducible measurement of infarct-related artery blood flow than the TIMI how grade, a nd has been linked to 30-day outcomes, but it has not vet been established how the CTFC correlates with late survival. METHODS Of 1,001 patients with acute myocardial infarction presenting withi n 4 h of symptom onset, 882 underwent angiography at approximately three we eks. Infarct artery flow was assessed, blinded to clinical outcomes, accord ing to the CTFC and TIMI flow grade. Late cardiac mortality and survival we re determined in 97.5% of patients. RESULTS The mean CTFC was 40 +/- 29 in 644 patent infarct arteries (median, 34 [interquartile range, 24 to 47]). The CTFC, assessed as a continuous un ivariate variable, was found to be a predictor of five-year survival, as wa s the TIMI flow grade (both p < 0.001). On multivariate analysis, factors a ssociated with five-year survival included the ejection fraction or end-sys tolic volume index (both p < 0.001), exercise duration (p = 0.005), age(p = 0.008), diabetes (p = 0.02) and CTFC (p = 0.02) or TIMI flow (p = 0.02). T he same factors, except for the CTFC and TIMI flow grade, were predictors o f 10-year survival. CONCLUSIONS The CTFC three weeks after myocardial infarction was an indepen dent predictor of five-year survival, but not 10-year survival. Although th e CTFC provided additional prognostic information within TlMI flow grades, its superiority was not demonstrated. (C) 2000 by the American College of C ardiology.