Editorial
Identifying failure to achieve complete (TIMI 3) reperfusion following thrombolytic treatment: how to do it, when to do it, and why it's worth doing
| The first 150 words of the full text of this article appear below. |
The
TIMI scoring system has been used extensively to report infarct related
artery patency in trials of thrombolytic treatment. In the initial
studies no distinction was made between TIMI 2 and 3 flow, both being
considered to represent an open artery. Karagounis and colleagues
reported data from the TEAM-2 study in 1992 suggesting that the
outcomes of patients with TIMI 2 flow were closer to those of patients
with no reperfusion (TIMI 0/1) than they were to patients with
"complete" reperfusion (TIMI 3).1 The GUSTO
angiographic substudy reported TIMI 2 and TIMI 3 flow as separate
groups; 30 day mortality was 8.9% for patients with TIMI 0/1 flow at
90 minute angiography compared to 7.4% for TIMI 2 flow and 4.4% for
TIMI 3 flow. The size of the study precluded this impressive 40%
relative reduction in mortality between TIMI 2 and 3 from reaching
significance (p = 0.08), but left ventricular function was
significantly better in patients achieving TIMI 3 flow compared
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