Impact of coronary flow restoration just before stent deployment in primary percutaneous coronary intervention

This study aimed to investigate the relationship between the restoration of coronary flow just before stent deployment and the final thrombolysis in myocardial infarction (TIMI) flow grade 3 in patients with ST-segment elevation myocardial infarction (STEMI) whose initial TIMI flow grade <= 1. In primary percutaneous coronary intervention (PCI), initial TMI flow grade <= 1 is closely associated with suboptimal final TIMI flow grade. We included 466 STEMI patients with initial TIMI flow grade <= 1 and divided into a restored flow group or an unrestored flow group according to the TIMI flow grade just before stent deployment. The primary endpoint was the achievement of final TIMI flow grade 3. We compared clinical characteristics between the two groups and performed a multivariate logistic analysis to investigate the association between the coronary flow restoration and the final TIMI flow grade. The prevalence of final TIMI flow grade 3 was significantly higher in the restored flow group than the unrestored flow group. The multivariate logistic regression analysis revealed that the restoration of coronary flow just before stent deployment was significantly associated with final TIMI flow grade 3 (OR 7.771, 95% CI 3.412-17.699, p < 0.001). The restoration of coronary flow just before stent deployment was significantly associated with the achievement of final TIMI flow grade 3 in STEMI patients with initial TIMI flow grade <= 1. Interventional cardiologist may pay more attention to the coronary flow restoration just before stent deployment when the initial TIMI flow grade is <= 1.