Risk Factors of Increased Corrected TIMI Frame Count in Angioplasty of Culprit Lesion after non-ST Elevation Acute Coronary Syndrome

Introduction: Non-ST elevation acute coronary syndromes (NSTE-ACS) are among the leading causes of death worldwide. The cornerstone of management strategies for NSTE-ACS is revascularization and reestablishment of coronary blood flow. However, in some patients, coronary blood flow may not be achieved despite of successful coronary intervention. However, the possible risk factors for development of abnormal coronary reflow in NSTE-ACS patients is not clearly addressed in the literature. Evaluation of risk factors relating to corrected TIMI frame count (cTFC) as an indicator of coronary artery reperfusion is the purpose of present study. Material and Methods: Every NSTE-ACS patients undergoing coronary interventions enrolled in present cross sectional study. Demographic data alongside of the conventional cardiac risk factors, biochemical serum markers and angiographic findings during coronary interventions were documented for each patient. T-test and Mann-Whitney test were used to evaluate the relation between mean CTFC and demographic, biochemical and angiographic findings. Linear regression was used for demonstrating the possible predictive model for CTFC in NSTE-ACS patients. Results: Among 210 NSTE-ACS patients, most of them were male (53.8%) and females had greater mean CTFC than males (P=0.044). Those patients who were smoker, hypertensive or diabetic had greater mean CTFC levels (P=0.017, P=0.001 and P=0.003 respectively). While those who had stent size larger than 20mm and presence of thrombosis before intervention had significantly greater CTFC (P=0.001 for both). Only blood sugar and creatinine level were correlated with mean CTFC, indicating that increase in such serum parameters will increase CTFC (P=0.001 for both). Using coronary stents larger than 20mm increased the mean CTFC for 25%. Conclusion: In contrast to ST segment elevation myocardial infarction, the risk factors for abnormal reperfusion following coronary interventions in NSTE-ACS is not clearly studied. The present study demonstrated that female gender, hypertension, diabetes mellitus, blood sugar level, creatinine level and stent size are related to cTFC and thrombotic lesions as a possible indicator of abnormal coronary reperfusion.