A population-based evaluation of the thrombolysis in myocardial infarction risk score for unstable angina and non-ST elevation myocardial infarction
| Autor: | Karen M. Smith, Stephen J. Monroe, David S. Sheps, Carl J. Pepine, Beth A Bartholomew, Susan P. McGorray |
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| Rok vydání: | 2004 |
| Předmět: |
education.field_of_study
Acute coronary syndrome medicine.medical_specialty Framingham Risk Score Unstable angina business.industry ST elevation Population General Medicine Chest pain medicine.disease Internal medicine medicine Cardiology cardiovascular diseases Myocardial infarction medicine.symptom Risk factor Cardiology and Cardiovascular Medicine education business |
| Zdroj: | Clinical Cardiology. 27:74-78 |
| ISSN: | 0160-9289 |
| Popis: | Background: The Thrombolysis in Myocardial Infarction risk score (TIMI-RS) for unstable angina/non-ST elevation myocardial infarction (MI) was developed in patients presenting with unstable angina accompanied by high-risk features or non-ST elevation MI to determine early risk stratification. Hypothesis: The validity in patients presenting for emergency care with symptoms suggestive of acute coronary syndrome (ACS) has not been well established, and the present study sought to do so by evaluating the TIMI-RS in a prospective fashion. Methods: A prospective TIMI-RS using seven variables was calculated in 245 patients admitted to the hospital with symptoms suggestive of ACS: (1) age > 65, (2) three or more cardiac risk factors, (3) ST deviation, (4) aspirin use within 7 days, (5) two or more anginal events over 24 h, (6) history of coronary stenosis, and (7) elevated troponin. Patients were contacted at 30 days and data were collected concerning major adverse cardiac events. Results: In patients presenting with chest pain, a higher TIMI-RS was associated with an increase in major adverse cardiac events within 30 days. We found that the 30-day event rate was 0% for a score of 1, 20% for a score of 2, 24% for a score of 3, 42% for a score of 4, 52% for a score of 5, and 70% for a score of 6 or 7 (p < 0.0001). Conclusions: The TIMI-RS successfully differentiates early risk for major adverse cardiac events in a general population presenting with symptoms suggestive of acute coronary syndrome. A simple bedside calculation of the TIMI-RS provides rapid risk stratification, allowing facilitation of therapeutic decision making in patients with symptoms suggestive of ACS. |
| Databáze: | OpenAIRE |
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