Is the corrected TIMI frame count an independent predictor of adverse outcome?

Independent Predictor of Adverse Outcome? To the Editor: The corrected TIMI frame count (cTFC) has evolved into a standard measurement in many angiographic core laboratories. Although the reproducibility of the cTFC has been demonstrated,1,2 its superiority to TIMI flow grading has remained in question. Work done in our core laboratory has not found the cTFC to have predictive value independent of TIMI flow grading.3 The recent analysis by Gibson et al4 is the first to show that the cTFC correlates with adverse clinical outcomes. However, we are concerned that the analysis examined both cTFC and TIMI flow in separate multivariate models. This approach circumvents the real question of whether the cTFC adds any prognostic information over and above standard TIMI flow grading in a core laboratory setting. If not, the added time and substantial effort needed to measure cTFC cannot legitimately be justified.