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✍ Scribed by Upendra Kaul

• Publisher: John Wiley and Sons
• Year: 2003
• Tongue: English
• Weight: 36 KB
• Volume: 59
• Category: Article
• ISSN: 1522-1946
• DOI: 10.1002/ccd.10590

✦ Synopsis

We would like to comment on several issues of concern in the recent article by Kaul et al. [1] that presented the results of the Integrilin in Acute Myocardial Infarction (INAMI) stenting study. First, the authors state that the decrease in the rate of TIMI flow grade 3 from 93% immediately following the primary PCI to 86% prior to hospital discharge was statistically significant at P Ͻ 0.05 using the Fisher's exact test. Based on a sample size of 55 patients as stated in the article, we calculate the P value with these percentages as P ϭ 0.360 using the Fisher's exact test (for either a two-or a three-way comparison). Likewise, the authors state the decrease in the rate of TIMI myocardial perfusion grade 3 from 87% immediately following the primary PCI to 78% prior to hospital discharge was statistically significant at P Ͻ 0.05 using the Fisher's exact test. We calculate the P value with these percentages as P ϭ 0.272 using a three-way comparison and P ϭ 0.313 using a two-way comparison with the Fisher's exact test.

The authors state that the corrected TIMI frame count (CTFC) decreased from 25.7 Ϯ 7.2 poststent to 22.9 Ϯ 6.8 frames. In the discussion, this decrease in CTFC is noted as "a disturbing feature," suggesting a lower CTFC indicates poorer coronary flow. On the contrary, a lower CTFC indicates faster, i.e., better, coronary flow and is associated with improved clinical outcomes in a study of more than 1,200 patients [2,3].