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Frequency, correlates, and clinical implications of myocardial perfusion after primary angioplasty and stenting, with and without glycoprotein IIb/IIIa inhibition, in acute myocardial infarction

Costantino O. Costantini, MD^*, Gregg W. Stone, MD, FACC^*,*, Roxana Mehran, MD, FACC^*, Eve Aymong, MD^*, Cindy L. Grines, MD, FACC, David A. Cox, MD, FACC, Thomas Stuckey, MD, FACC, Mark Turco, MD, FACC^||, Bernard J. Gersh, MD, FACC^¶, James E. Tcheng, MD, FACC^**, Eulogio Garcia, MD, John J. Griffin, MD, FACC, Giulio Guagliumi, MD, Martin B. Leon, MD, FACC^* and Alexandra J. Lansky, MD, FACC^*

^* Cardiovascular Research Foundation and Lenox Hill Hospital, New York, New York, USA
William Beaumont Hospital, Royal Oak, Michigan, USA
Mid Carolina Cardiology, Charlotte, North Carolina, USA
Moses Cone Hospital, Greensboro, North Carolina, USA
^|| Washington Adventist Hospital, Takoma Park, Maryland, USA
^¶ Mayo Clinic, Rochester, Minnesota, USA
^** Duke University Medical Center, Durham, North Carolina, USA
Hospital Gregorio Maranon, Madrid, Spain
Virginia Beach General Hospital, Virginia Beach, Virginia, USA
Ospedali Riuniti di Bergamo, Bergamo, Italy

View larger version (18K): [in a new window]   Figure 1 Baseline and final Thrombolysis In Myocardial Infarction (TIMI) flow rates (left) and myocardial blush grades (right) in 1,301 patients. Black bars = grade 0/1; hatched bars = grade 2; white bars = grade 3. PCI = percutaneous coronary intervention.

View larger version (20K): [in a new window]   Figure 2 Cumulative survival according to final myocardial blush grade (MBG) in all patients (upper graph) and in those with post-procedure Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 (lower graph). PCI = percutaneous coronary intervention.

View larger version (15K): [in a new window]   Figure 3 Multivariate predictors of one-year mortality. CI = confidence interval; HR = hazard ratio; TIMI = Thrombolysis In Myocardial Infarction.

View larger version (26K): [in a new window]   Figure 4 Incidence of final myocardial blush grade by randomized treatment strategy. Black bars = balloon angioplasty; bars with horizontal lines = angioplasty + abciximab; white bars = stent; bars with diagonal lines = stent + abciximab.