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Correlation Between Corrected TIMI Frame Count with the Extent of Myocardial Fibrosis on ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention Munandar, Reza Maulana; Herminingsih, Susi; Ardhianto, Pipin; Gharini, Putrika Prastuti Ratna; Sobirin, Mochamad Ali
Journal of Biomedicine and Translational Research Vol 10, No 1 (2024): April 2024
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v10i1.20872

Abstract

Background: Microvascular injury after primary percutaneous coronary intervention (PPCI) reperfusion contributes to necrosis propagation. Corrected TIMI Frame Count (CTFC) is a surrogate marker of microvascular dysfunction and can stratify in-hospital mortality risk in patients with final TIMI flow 3. The extent of myocardial fibrosis after STEMI is associated with a higher incidence of major cardiovascular events. This study aimed to determine the relationship between CTFC in the infarct-related artery and myocardial fibrosis area based on cardiac magnetic resonance (CMR) in STEMI patients undergoing PPCI.Methods: This retrospective cohort study included 31 STEMI patients who had undergone PPCI and CMR examination between days 60 and 75 after STEMI as the sample. CTFC was measured in the infarct-related artery from post-PPCI angiogram recordings. Myocardial fibrosis area was measured from late gadolinium enhancement CMR (LGE-CMR) imaging results.Results: In this study, the mean age was 51.61±10.49 years, 90.3% were male, non-anterior infarction location was 58.1%, mean total ischemic time was 489.48±228.33 minutes, mean CTFC was 27.4±9.3 frames, and mean myocardial fibrosis was 18.33±7.87%. There was no significant correlation found between CTFC and myocardial fibrosis (p=0.530), however total ischemic time had a positive and significant correlation with myocardial fibrosis (p=0.025, r=0.403).Conclusion: CTFC in the infarct-related artery is not correlated with myocardial fibrosis area in STEMI patients undergoing PCI.
External Validation of Major Adverse Cardiovascular Events’ Predictors in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention Raharjo, Robert Adrianto; Herminingsih, Susi; Ardhianto, Pipin; Herry, Yan
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (602.671 KB) | DOI: 10.36408/mhjcm.v8i2.569

Abstract

BACKGROUND: KARIADI risk score is a 0-to-9 point system based on Killip class, final TIMI flow, total ischemic time, creatinine level, blood glucose, systolic blood pressure, and age. This score was developed to predict the risk of in-hospital major adverse cardiovascular events (MACE) (a composite of death, stroke, urgent revascularization, cardiogenic shock, acute pulmonary edema, or arrhythmia) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention (PPCI), but its performance has never been validated externally. OBJECTIVE: To perform external validation on KARIADI risk score. METHOD: This study was a prospective cohort study on 109 STEMI patients undergoing PPCI in Dr. Kariadi General Hospital during January-November 2020. Each sample underwent KARIADI risk score assessment and follow-up for in-hospital MACE. The risk score validation was performed by assessing calibration [measured with calibration-in-the-large (alpha), calibration slope (beta), and calibration plot] and discrimination performance [measured with c-statistic and receiver operating characteristic curve). RESULT: Eighteen patients (16.5%) had MACE. KARIADI risk score demonstrated unsuitable calibration (alpha -0.39, beta 0.71, unfit calibration plot) and moderate discrimination performance (c-statistic 0.75, 95% CI 0.62-0.87). CONCLUSION: KARIADI risk score is not valid in predicting in-hospital MACE in patients with STEMI undergoing PPCI. Keywords: ST-segment elevation myocardial infarction, primary percutaneous coronary intervention, KARIADI risk score, external validation