Novel Acute Collateral Flow Index in Patients With Total Coronary Artery Occlusion During ST-Elevation Myocardial Infarction

摘要

Background: The effect of collaterals to occluded coronary arteries during ST-elevation myocardial infarction (STEMI) is unclear. The conventional CVP-based formula to calculate collateral flow index during STEMI yields values higher than in elective patients, which prompted derivation of a modified formula, pertinent in STEMI when left ventricular mean diastolic pressure (LVMDP) is the extravascular pressure limiting collateral flow. We aimed to evaluate this new LVMDP-based acute collateral flow index (ACFI). Methods and Results: The pressure distal to coronary artery occlusion (P_d) was measured during intervention in 111 consecutive STEMI patients, 67 (61%) of whom underwent primary intervention, followed for 58 months. ACFI (0.18±0.17, median 0.15) correlated with both P_d and collateral grade (P