Seasonal changes in coronary flow on the basis of TIMI Flow Grade in patients with acute myocardial infarction undergoing primary coronary angioplasty

Abstract

Ambient temperature can play a very important role in the pathogenesis of acute MI. The autonomic response to cold leads cardiac workload due to an increase in the need for oxygen, an increase in sympathetic tone, and greater vascular resistance, which can also cause unwanted accidents. Several scoring systems have been proposed in terms of diagnosis-treatment for STEMI, which helps in decision-making, one of which is the TIMI flow grade, which is based on the blood supply to the coronary arteries from a score of 0 to 3. This study aims to evaluate seasonal changes in coronary flow based on TIMI flow grade in patients with acute myocardial infarction undergoing primary coronary angioplasty. Materials and Methods: In this study, patients diagnosed with acute myocardial infarction who underwent primary coronary angioplasty were included in the study. Patient information including age, sex, previous disease history, type of infarction, and angioplasty results, including the number of involved vessels, involved vessels and the type of treatment chosen for the patient, duration of hospitalization, patient outcome, and TIMI flow grade were recorded. Results: Among 400 patients with acute MI during one year,a statistically significant relationship was observed between the Timi Flow Grade and the season of referral,so that the frequency of high grade was higher in the cold seasons.66% of patients were referred in the cold seasons of the year and also significantly in both hot (79.4%) and cold (74.2%) seasons, the most of the AMI cases were male. Regarding other demographic characteristics of the patients, no difference was observed between the hot and cold seasons of the year. In terms of vital signs, the mean systolic blood pressure of patients referred to in cold seasons was significantly higher than that of patients referred to in hot seasons, but no difference was observed in terms of heart rate and EF. The highest frequency of AMI type was related to Inferior MI and Anterior MI, respectively; The frequency of Anterior MI was significantly higher in the hot seasons (20.6% vs. 15.9%; p=0.012) and the frequency of Inferior MI cases was higher in the cold seasons (35.2% vs. 25 percent; p=0.023). of LCX involvement in cold seasons was significantly higher than in hot seasons (45.5% vs. 32.4%; p=0.008). Significantly, the frequency of mortality cases was higher in cold seasons than in hot seasons (4.5% vs. 2.9%; p=0.034).