Results
From January 2017 to December 2019, 306 consecutive patients diagnosed with acute inferior MI were enrolled in this study after discharge following the review of their records. The number of patients excluded during the follow-up period and reasons for exclusion were as follows: 23 patients (0.07%) were excluded due to TIMI 0-1 flow, 7 patients (0.02%) due to bundle branch blocks, and 2 patients (0.006%) due to chronic renal failure. A total of 274 patients (median age 56.8 ± 9.8 years) who presented with the first acute inferior myocardial infarction and whose infarct-related artery was the right coronary artery were included in the study. Primary percutaneous coronary intervention (PPCI) was performed in all patients. According to patients with TIMI 2-3 flow after PPCI, patients were divided into two groups of MBG 0-1 and MBG 2-3. In this study, 62 and 212 patients had MBG 0-1 and MBG 2-3, respectively. The demographics and laboratory parameters of the patients are shown in Table 1. As shown in Table 1, no significant difference was found between the two groups in demographics and clinical characteristics. Compared with the MBG 2-3 groups, the MBG 0-1 groups had a significantly lower left ventricular ejection fraction and higher white blood count, and the differences were statistically significant.
Comparison of angiographic and electrographic parameters between groups is shown in Table 2. Fragmented QRS was more pronounced in patients with impaired microvascular reperfusion. MBG 2-3 groups and MBG 0-1 groups were similar in pain-to-balloon time (4.64 ± 1.84 vs. 57 ± 1.8, p: 0.78). Compared with the MBG 2-3 groups, the ST segment resolution at one hour was significantly lower and the QRS duration was significantly higher in the MBG 0-1 groups. However, the TIMI frame count was higher in the MBG 0-1 groups. In this study, there was no statistically significant difference between the two groups and between the severity of coronary artery disease according the Gensini score. However, the Gensini scores were high in the patients of the MBG 0-1 group.
After the multivariate logistic regression models were adjusted to fragmented QRS [OR: 6.5 (1.4-28.6), p = 0.01], ST segment resolution at one hour [OR: 0.30 (0.14-0.67), p = 0.003], TIMI frame number [OR: 1.05 (1.01-1.09), p = 0.004], age, gender and pain-to-balloon time in patients who underwent PPCI, myocardial flushing was found to have deteriorated (as shown in Table 3).