The timi risk score could, thus, be suitable for early risk stratification and subsequent treatment of stemi patients who receive reperfusion therapy, morrow et al conclude. A timi risk score of 0 or 1 does not equal zero risk of adverse outcome. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Timi risk score for st elevation myocardial infarction stemi is an important tool to assess mortality risk. The cstatistics predictive value of the timi risk score for mortality was 0. The timi risk score for unstable angina or non st segment elevation mi was derived in the test cohort by selection of independent prognostic variables using multivariate logistic regression, assignment of value of 1 when a factor was present and 0 when it was absent, and summing the number of factors present to categorize patients into a level. The thrombolysis in myocardial infarction timi risk score is a prognostic risk stratification system that categorizes the risk of death and ischemic events in patients with unstable angina nonst elevation myocardial infarction and provides a basis for therapeutic decision making. Unclear if this risk score can be used in patients with. The purpose of this study was to determine if the thrombolysis in myocardial infarction timi risk score for stemi applied to patients undergo primary. Timi risk scorethrombolysis in myocardial infarction characteristics points historical age. Thrombolysis in myocardial infarction timi score for.
Although there are multiple methods of risk stratification for st. Thrombolysis in myocardial infarction timi risk score. The parameters for the calculator include dm, history of htn or angina, systolic blood pressure, heart rate, killip class iiiv, body weight, anterior lead st elevation of left bbb, time to treat, age. The risk score showed a 40fold graded increase in mortality, with scores ranging from 0 to 8 p score of 0. Pdf the timi risk score for stemi predicts inhospital mortality. Stemi extensive anterior wall onset 4 hours killip i timi score 314. This article is from iranian red crescent medical journal, volume 16. Timi risk score for secondary prevention trs2p is a simple ninepoint risk stratification tool, derived in patients with previous mi. Derivation and validation study derived from thrombolysis in myocardial infarction timi 11b trial and essence trials. Estimates mortality for patients with unstable angina and nonst elevation mi. Abstractbackground chest pain is one of the most common causes of the admission to the.
The timi risk score for stemi figure 2 showed a strong association with mortality at 30 days, with a 40fold graded increase in mortality between those with a risk score of 0 and those with a score 8 p trend score 5 identified 12% of patients with a mortality risk 2fold higher than the mean for the population. The thrombolysis in myocardial infarction timi score is used to determine the likelihood of ischemic events or mortality in patients with unstable angina or nonstsegment elevation myocardial infarction nstemi. The timi risk score for unstable anginanonst elevation mi. Prognostic value of timi score versus grace score in st. Female gender was not included in the timi risk score, as it was one of the five variables accounting for the remaining 3% of the predictive capacity for 30day mortality or 1. Data file collection and storage were approved by the commission nationale. Risk factors include family history of cad, hypertension, hypercholesterolemia, diabetes, or being a current smoker. Timi 9a and 9b were multicenter randomized trials evaluating the safety and efficacy of hirudin as an adjunct to fibrinolytic therapy tissue plasminogen activator or streptokinase at the physicians discretion. Timi risk score11 has been validated and can be used. The relationship between the predictive performance of the timi risk score for stemi and gender has not been evaluated in the setting of primary pci ppci. The purpose of this study was to determine if the thrombolysis in myocardial in farction timi risk score for stemi applied to patients undergo primary.
Does simplicity compromise accuracy in acs risk prediction. The timi risk score is an easy bedside calculation mostly based on the patients medical history and a few initial tests ecg and initial labs in patients presenting to the emergency department ed with unstable angina or nstemi when trying to assess their risk for cardiac related ischemic events and death within the first 14 days after presenting to the ed. Inhospital mortality was analysed in 8,073 1,920 23. Seven of 12 characteristics significantly predicted adverse outcome. The parameters for the calculator include age, cad risk factors, aspirin, severe angina, cardiac markers, and st deviation. The calculator thrombolysis in myocardial infarction timi score for st elevation acute myocardial infarction is used as a simple arithmetic sum of independent predictors of mortality.
The timi risk score for unstable anginanonst evelation mi. A method for prognostication and therapeutic decision making. The timi risk score for stemi is a weighted integer score based on 8 clinical risk indicators that can be easily ascertained at presentation. Thrombolysis in myocardial infarction timi score for usa. In patients with uanstemi, the timi risk score is a simple prognostication scheme that categorizes a patients risk of death and ischemic events and provides a basis for therapeutic decision making. The timi risk score for stemi predicts inhospital mortality. Validation of timi risk score for stemi international journal of. Cardiac pathways flowchart stemi diagnosed possible nsteacs intermediate low risk nsteacs high risk nsteacs i. Application of the timi risk score for stelevation mi in. Stemi extensive anterior wall onset 4 hours killip i timi score 314 free download as powerpoint presentation. Design, setting, and participants the risk score was evaluated among 84029. A timi score risk and a timi score in general, patients having multiple coronary risk factors, advanced age, rest angina, clinical left ventricular lv dysfunction, prior history of percutaneous coronary intervention. A retrospective analysis of the timi and grace risk scores plos one, nov 2009 krishna g.
Creatinine clearance cockcroft gault equation gfr calculators. Gender, timi risk score and inhospital mortality in stemi. Timi risk score for unstable angina or nonst elevation mi. Timi risk score for stelevation myocardial infarction. Esc guidelines for the management of acute coronary. Event rates increased significantly as the timi risk score increased in the test cohort in timi 11b. Stemi extensive anterior wall onset 4 hours killip i timi. Timi risk score for unstable anginanonst elevation. The timi risk score for stemi was assessed in an external data set from the timi 9 trial. Pdf the utility of the timi risk index on admission for predicting.
The timi risk score for stemi predicts inhospital mortality and. Objective to validate the timi risk score in a population of stemi patients reflective of contemporary practice. Timi risk score for stelevation myocardial infarction aha journals. Comparison of the grace, heart and timi score to predict. New risk score for patients with acute chest pain, nonstsegment deviation, and normal troponin concentrations. Stemi patients should obviously undergo pci or thrombolysis, depending on availability and standard of care at ones hospital. The calculator thrombolysis in myocardial infarction timi score for unstable angina non st elevation myocardial infarction is used to guide patient care in unstable angina. A total of 1957 patients with uanstemi were assigned to receive unfractionated heparin test co hort and 1953 to receive enoxaparin in timi 11b. It is thought to have potential to improve the management of patients presenting to hospital with. There are no data on the predic tive performance of the timi risk score when applied to a community. The prognostic discriminatory capacity of the timi risk score was comparable to the full multivariable model c statistic 0.
Timi risk score for ua and non stemi antman em et al. Here, we compared inhospital mortality and predictive performance of the time risk score between belgian women and men undergoing ppci. Timi risk score predicts death in stemi patients medscape. Atherothrombotic risk stratification was performed using the trs2p score.
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