{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:04:36Z","timestamp":1781089476405,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: People with non-ST-segment elevation myocardial infarction (NSTEMI) with an occluded culprit vessel represent a unique subset of patients; however, their long-term outcomes remain unclear. This study aimed to compare 5-year mortality between NSTEMI patients treated with percutaneous coronary intervention (PCI) based on TIMI flow states in the culprit vessel on presentation (TIMI 0-1 compared to TIMI 2-3). Methods: A retrospective analysis of prospectively collected data of all NSTEMI patients who underwent PCI from 2012 to 2019 at a tertiary cardiac center (The Freeman Hospital, Newcastle-Upon-Tyne, UK) with follow up for 5 years until January 2024. Patients were identified from the database and categorized based on pre-procedural TIMI flow in the culprit vessel. A propensity score was used to pair TIMI 0-1 patients with a matched cohort of TIMI 2-3 patients. The primary outcome was 5-year all-cause mortality. Results: A total of 775 patients with TIMI 0-1 flow were matched with 750 patients who had TIMI 2-3 flow. Patients with TIMI 0-1 flow were more likely to have transient ST elevation (24% vs. 18%, p &lt; 0.001) or Q waves (4% vs. 1%, p &lt; 0.001) compared with patients who had TIMI 2-3 flow. They were also more likely to have moderately to severely impaired left ventricular systolic function compared with patients with TIMI 2-3 flow (21% vs. 16%, p = 0.01). In-hospital mortality (1.2% vs. 1.2%, p = NS), 1-year mortality (5% vs. 6.9%, p = NS), and 5-year mortality (16% vs. 18%, p = 0.34) were not significantly different between the two groups. The use of glycoprotein IIb\/IIIa antagonists was associated with lower mortality, HR 0.64 (0.46 to 0.87). Conclusions: NSTEMI patients with occluded culprit vessels who underwent PCI had similar in-hospital and long-term outcomes to patients with patent culprit vessels. The use of glycoprotein IIb\/IIIa inhibitors appears to be associated with lower mortality.<\/jats:p>","DOI":"10.3390\/jcm15124486","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:25:17Z","timestamp":1781083517000},"page":"4486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-Term Outcomes in NSTEMI Patients Based on Coronary TIMI Flow State on Presentation"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7036-0787","authenticated-orcid":false,"given":"Tarek","family":"Abdeldayem","sequence":"first","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilal","family":"Khan","sequence":"additional","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0811-7679","authenticated-orcid":false,"given":"Mohamed","family":"Farag","sequence":"additional","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2750-2444","authenticated-orcid":false,"given":"Ioakim","family":"Spyridopoulos","sequence":"additional","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"},{"name":"Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE7 7DN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3088-8878","authenticated-orcid":false,"given":"Mohammad","family":"Alkhalil","sequence":"additional","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2949-7711","authenticated-orcid":false,"given":"Scott","family":"Wilkes","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Sunderland, Sunderland SR1 3SD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanouil S.","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute, Minneapolis, MN 55407, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8483-2178","authenticated-orcid":false,"given":"Bilal","family":"Bawamia","sequence":"additional","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3642-318X","authenticated-orcid":false,"given":"Mohaned","family":"Egred","sequence":"additional","affiliation":[{"name":"Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK"},{"name":"School of Medicine, University of Sunderland, Sunderland SR1 3SD, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Licordari, R., Costa, F., Garcia-Ruiz, V., Mamas, M.A., Marquis-Gravel, G., Hernandez, J.M.d.l.T., Doblas, J.J.G., Jimenez-Navarro, M., Rodriguez-Capitan, J., and Urbano-Carrillo, C. 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