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).