Impact of Time Delay on Thrombus Burden and TIMI-Flow in ST Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention


Authors: Khaled Abdelgaber Abozeid, Ahmed Farouk Alaarag, Timoor Mostafa Abdallah, and Mai Mohamed Salama
Page Range: 157-168
Published in: World Heart Journal, 14#2 (2022)
ISSN: 1556-4002

ISBN: N/A Category:

Table of Contents


Background: Acute myocardial infarction (MI) diagnosis consists of evidence of myocardial injury clinically coping with acute myocardial ischemia. ST-Segment Elevation Myocardial Infarction (STEMI) treatment seeks to restore coronary artery blood supply (Reperfusion) as early as possible. As time is crucial in life-saving, limited data are available on the clinical significance of both combined thrombus burden score and TIMI flow score with ischemic time in STEMI patients. Objective: To determine the effect of total ischemia time delay on Thrombus burden and TIMI-flow scores in patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Subjects and methods: After clearance from the ethics committee of the hospital and obtaining written informed consent, patients were recruited in this study. The study included 248 consecutive patients with STEMI, admitted from June 2019 to December 2020, to the Cardiology Department of Tanta University Hospital and Tanta Insurance Hospital, Tanta, Egypt. All volunteers underwent primary PCI within 15 months, which were categorized by total ischemic time (symptom onset to wire crossing time) into three groups. Group 1: 48 patients presented from 0 to 2 hours; Group 2: 80 patients presented from 2 to 6 hours; Group 3: 120 patients presented more than 6 hours. Diagnostic criteria were based on AHA and ESC guidelines. Results: A significant relationship was found between the total ischemic time with initial TIMI flow score, final TIMI flow score, initial Thrombus Burden score and post flow achievement Thrombus Burden Score (TBS) (P < 0.001). Conclusions: The longer the total ischemic time, the higher the thrombus burden score and the lower the TIMI flow score.

Keywords: Thrombus burden, TIMI-Flow, ST-Elevation Myocardial infarction, primary PCI.

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