Abstract
Primary angioplasty is an effective method to achieve myocardial reperfusion in ST-elevated myocardial infarction (MI). The objective of this study was to determine the independent factors that could predict mortality in MI patients treated with primary angioplasty and to analyze the prognostic value of tissue reperfusion parameters in those patients. A prospective observational study was performed in 380 consecutive patients with ST-elevated MI treated with primary angioplasty at a single hospital. Early mortality was 8.9%. Upon univariate analysis, the following variables were associated with significantly higher mortality: age, ejection fraction (EF), multivascular disease, anterior location of MI, lack of resolution of ST segment, flow 0-1 of TIMI, grade 0-1 of blush index and delay time above 4 hours. Multivariate analysis yielded the following independent variables as predictors of mortality: age, degree of heart failure (Killip index) and degree of myocardial perfusion (blush index). The independent predictive factors of mortality in patients with ST-elevated MI and treated with primary angioplasty are: age, degree of heart failure (Killip index) and degree of myocardial reperfusion (blush index). The resolution of ST segment and blush index represent additional prognostic variables in patients with good epicardial reperfusion.
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