Correlation between Timi Risk Score and Clinical Outcome in Patients with Unstable Angina Pectoris

Open access

Abstract

Given Taking that the TIMI score is a major predictor of MACE, this study aimed to determine the value of the TIMI risk score in predicting poor outcomes (death, myocardial infarction, recurrent pain) in patients presenting with unstable angina pectoris in short-term observation. A total of 107 patients with APns were examined at the Clinical Centre Kragujevac and were included in the investigation. The TIMI score was determined on the first day of hospitalization. During hospitalization, the following factors were also observed: troponin, ECG evolution, further therapy (pharmacologic therapy and/or emergency PCI or CABG), age, hypertension and hyperlipidaemia. The low-risk group (TIMI 0 - 2) included 30.8% of patients, whereas 47.6% of patients were in the intermediate-risk group (TIMI 3 - 4), and 21.5% of patients were in the high-risk group (TIMI 5 - 7). Good outcomes (without adverse event) and poor outcomes (death, myocardial infarction, and recurring chest pain) were dependent on the TIMI risk score. The increase in TIMI risk score per one unit increased the risk of a poor outcome by 54%. Troponin and TIMI risk score were positively correlated. Our results suggest that the TIMI risk score may be a reliable predictor of a poor outcome (MACE) during the short-term observation of patients with APns. Moreover, patients identified as high-risk benefit from early invasive PCI, enoxaparin and Gp IIb/IIIa inhibitors. Th us, routine use of the TIMI risk score at admission may reduce the number of patients not recognized as high-risk.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Fernandez-Berges D Bertomeu-Gonzalez V Sanchez PL Cruz-Fernandez JM Arroyo R Barriales Alvarez V Carrasco Sanchez FJ Dalli E Castro Beiras A Kaski JC. (2011). Clinical scores and patient risk stratification in non-ST elevation acute coronary syndrome. Int J Cardiol. 146: 219-224.

  • 2. De Aralijo Goncalves P Fereira J Aguiar C Seabra-Gomes R. (2005). TIMI PURSUIT and GRACE risk scores: sustained prognostic value and interaction with revascularisation in NSTE-ACS. Eur Heart J. 26: 865-872.

  • 3. Aragam KG Tamhane UU Kline-Rogers E Li J Fox KA Goodman SG Eagle KA Gurm HS. (2009). Does simplicity compromise accuracy in ACS risk prediction? A retrospective analysis of the TIMI and GRACE risk scores. PLoS One. 4: e7947.

  • 4. Ang DS Wei L Kao MP Lang CC Struthers AD. (2009). A comparison between B-type natriuretic peptide global registry of acute coronary events (GRACE) score and their combination in ACS risk stratification. Heart. 95: 1836-1842.

  • 5. Pencina MJ D’Agostino RB Sr Steyerberg EW. (2011). Extensions of net reclassification improvement calculations to measure usefulness of new biomarkers. Stat Med. 30: 11-21.

  • 6. Schiele F Meneveau N Seronde MF Chopard R Descotes-Genon V Dutheil J Bassand JP. (2010). C-reactive protein improves risk prediction in patients with acute coronary syndromes. Eur Heart J. 31: 290-297.

  • 7. Eggers KM Lagerqvist B Venge P Wallentin L Lindahl B. (2009). Prognostic value of biomarkers during and after non-ST-segment elevation acute coronary syndrome. J Am Coll Cardiol. 54: 357-364.

  • 8. Carruthers KF Dagbous OH Flather MD Starkey I Jacob A MacLeod D et al. (2005). behalf of the GRACE investigators. Contemporary management of acute coronary syndromes: does the practice match the evidence? The global registry of acute coronary events (GRACE). Heart. 91: 290-298.

  • 9. Yan AT Yan RT Huynh T Casanova A Raimondo FE Fitchett DH Langer A Goodman SG. (2009). Understanding physicians’ risk stratification of acute coronary syndromes: insights from the Canadian ACS 2 Registry. Arch Intern Med. 169: 372-378.

  • 10. Gale CP Manda SOWeston CF Birkhead JS Batin PD Hall AS. (2009). Evaluation of risk scores for risk stratification of acute coronary syndromes in the Myocardial Infarction National Audit Project (MINAP) database. Heart. 95: 221-227.

  • 11. Morrow DA (2010). Cardiovascular risk prediction in patients with stable and unstable coronary heart disease. Circulation. 121: 2681-2691.

  • 12. Mehta SR Granger CB Boden WE Steg PG Bassand JP Faxon DP Afzal R Chrolavicius S Jolly SS Widimsky P Avezum A Rupprecht HJ Zhu J Col J Natarajan MK Horsman C Fox KA Yusuf S. (2009). Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 360: 2165-2175.

  • 13. Morrow DA Antman EM Fox KA Knite HD Giuliano R Myrphy SA McCabeand CH Braunwald E. (2010). One-year outcomes after a strategy using enoxaparin vs. unfractionated heparin in patients undergoing fibrinolysis for ST-segment elevation myocardial infarction: 1-year result of the EXTRACT-TIMI 25 trial. Eur Heart J. 31: 2097-2102.

  • 14. McCullough PA Gi bson CM DiBattiste PM et al. (2004). For the TACTIS TIMI-18 Investigators: Timing of angiography and revascularisation in acute coronary syndromes: An analysis from the TACTIS TIMI-18 trial. J Interv Cardiol. 17: 81.

  • 15. Diderholm E Andren B Frostfeldt G et al. (2002). The prognosticand therapeutic implications of increased troponin levels and ST depresion in unstable coronary artery disease: the FRASC II invasive troponin T electrocardiogram sybstudy. Am Heart J. 143: 760-767.

Search
Journal information
Impact Factor


CiteScore 2018: 0.13

SCImago Journal Rank (SJR) 2018: 0.118
Source Normalized Impact per Paper (SNIP) 2018: 0.079

Metrics
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 235 130 4
PDF Downloads 113 69 1