OBJECTIVE: To assess the prognostic utility of the Thrombolysis in Myocardial Infarction (TIMI) risk score in patients in the emergency department (ED) evaluated for possible acute coronary syndrome (ACS). BACKGROUND: The ability of the TIMI risk score to risk stratify patients at initial presentation in the ED with chest pain of unclear etiology is uncertain. METHODS: We investigated the prognostic utility of the TIMI risk score in 947 consecutive patients evaluated in the ED for possible ACS. A multivariate analysis was done to evaluate the independent predictive power of the individual components of the TIMI risk score to predict an adverse event at 30 days (all-cause death, myocardial infarction, and coronary revascularization). RESULTS: There were 151 (16%) patients diagnosed with ACS. At 30 days there were 48 (5%) deaths, 84 (9%) myocardial infarctions, and 49 (5%) coronary revascularization procedures. The mean TIMI risk score was significantly higher in patients with an adverse event compared with those without (2.6 +/- 1.3 vs. 1.7 +/- 1.2, P < 0.0001). Four of the 7 TIMI risk factors (age > or = 65 years, ST segment deviation > or = 0.5 mm elevated troponin I, and coronary stenosis > or = 50%) were independently associated with adverse events. A simplified TIMI risk score was computed and was found to have similar prognostic ability as the 7 variable TIMI risk score. CONCLUSION: A modified TIMI risk score may simplify risk stratification of ED patients with undifferentiated chest pain.
OBJECTIVE: To assess the prognostic utility of the Thrombolysis in Myocardial Infarction (TIMI) risk score in patients in the emergency department (ED) evaluated for possible acute coronary syndrome (ACS). BACKGROUND: The ability of the TIMI risk score to risk stratify patients at initial presentation in the ED with chest pain of unclear etiology is uncertain. METHODS: We investigated the prognostic utility of the TIMI risk score in 947 consecutive patients evaluated in the ED for possible ACS. A multivariate analysis was done to evaluate the independent predictive power of the individual components of the TIMI risk score to predict an adverse event at 30 days (all-cause death, myocardial infarction, and coronary revascularization). RESULTS: There were 151 (16%) patients diagnosed with ACS. At 30 days there were 48 (5%) deaths, 84 (9%) myocardial infarctions, and 49 (5%) coronary revascularization procedures. The mean TIMI risk score was significantly higher in patients with an adverse event compared with those without (2.6 +/- 1.3 vs. 1.7 +/- 1.2, P < 0.0001). Four of the 7 TIMI risk factors (age > or = 65 years, ST segment deviation > or = 0.5 mm elevated troponin I, and coronary stenosis > or = 50%) were independently associated with adverse events. A simplified TIMI risk score was computed and was found to have similar prognostic ability as the 7 variable TIMI risk score. CONCLUSION: A modified TIMI risk score may simplify risk stratification of ED patients with undifferentiated chest pain.
Authors: E M Antman; M Cohen; P J Bernink; C H McCabe; T Horacek; G Papuchis; B Mautner; R Corbalan; D Radley; E Braunwald Journal: JAMA Date: 2000-08-16 Impact factor: 56.272
Authors: Charles V Pollack; Frank D Sites; Frances S Shofer; Keara L Sease; Judd E Hollander Journal: Acad Emerg Med Date: 2005-12-19 Impact factor: 3.451
Authors: Stuart W Zarich; Asad U Qamar; Michael J Werdmann; Lori S Lizak; Craig A McPherson; Larry H Bernstein Journal: Clin Chim Acta Date: 2002-12 Impact factor: 3.786
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