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Although extensively studied, defined modifiable risk factors and efficient management strategy are lacking. This study aims to determine the potential causes of suboptimal flow and associated impact on 30-day outcomes in patients presenting with anterior ST-elevation myocardial infarction (STEMI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated a total of 1104 consecutive patients admitted to our hospital from January 2016 to December 2018 with the diagnosis of anterior wall STEMI who had primary PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 245 patients (22.2%) had final post-PCI TIMI flow \u22642 in the LAD (suboptimal flow group) and 859 (77.8%) had final TIMI-3 flow (optimal flow group). The independent predictors of suboptimal flow were thrombus burden grade (Odds ratio (OR) 1.848;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), age (OR 1.039 per 1-year increase; p\u2009&lt;\u20090.001), low systolic blood pressure (OR 1.017 per 1\u2009mmHg decrease; p\u2009&lt;\u20090.001), total stent length (OR 1.021 per 1\u2009mm increase; p\u2009&lt;\u20090.001), and baseline TIMI flow \u22641 (OR 1.674;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). The 30-day rates of major adverse cardiovascular events (MACE) and cardiac mortality were significantly higher in patients with TIMI flow \u22642 compared to those with TIMI-3 flow (MACE: adjusted risk ratio [RR] 2.021;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.025, cardiac mortality: adjusted RR 2.931;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.031).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Failure to achieve normal TIMI-3 flow was associated with patient-related (age) and other potentially modifiable risk factors (thrombus burden, admission systolic blood pressure, total stent length, and baseline TIMI flow). The absence of final TIMI-3 flow carried worse short-term clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-020-01673-0","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T11:03:49Z","timestamp":1598526229000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Predictors of suboptimal coronary blood flow after primary angioplasty and its implications on short-term outcomes in patients with acute anterior STEMI"],"prefix":"10.1186","volume":"20","author":[{"given":"Karim","family":"Elakabawi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sardar Ali","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hameed","family":"Ullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary S.","family":"Mintz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4141-0298","authenticated-orcid":false,"given":"Zuyi","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,27]]},"reference":[{"key":"1673_CR1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.pharmthera.2014.06.008","volume":"144","author":"G Guarini","year":"2014","unstructured":"Guarini G, Huqi A, Morrone D, Capozza P, Todiere G, Marzilli M. 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