OBJECTIVE: The TIMI risk score has been validated as a risk stratification tool in emergency department (ED) patients with potential acute coronary syndrome. The goal of this study was to assess its ability to predict adverse cardiovascular outcomes in cocaine-associated chest pain. METHODS: This was a prospective cohort study of ED patients with chest pain with cocaine use. Data included demographics, medical history, and TIMI risk score. The main outcomes were acute myocardial infarction, revascularization, or death within 30 days of ED presentation. RESULTS: There were 261 patient visits. Patients were 43.2+8 years old, 73% male, 92% black, and 75% smokers. There were 33 patients with the composite outcome. The incidence of 30-day outcomes according to TIMI score is as follows: TIMI 0, 3.7% (95% CI, 0.1-8.3); TIMI 1, 13.2% (5.7-20.7); TIMI 2, 17.1% (4.3-29.8); TIMI 3, 21.4% (4.4-38.4); TIMI 4, 20.0% (0.1-43.6); TIMI 5/6, 50.0% (0.1-100). CONCLUSIONS: The TIMI risk score has no clinically useful predictive value in patients with cocaine-associated chest pain.
OBJECTIVE: The TIMI risk score has been validated as a risk stratification tool in emergency department (ED) patients with potential acute coronary syndrome. The goal of this study was to assess its ability to predict adverse cardiovascular outcomes in cocaine-associated chest pain. METHODS: This was a prospective cohort study of ED patients with chest pain with cocaine use. Data included demographics, medical history, and TIMI risk score. The main outcomes were acute myocardial infarction, revascularization, or death within 30 days of ED presentation. RESULTS: There were 261 patient visits. Patients were 43.2+8 years old, 73% male, 92% black, and 75% smokers. There were 33 patients with the composite outcome. The incidence of 30-day outcomes according to TIMI score is as follows: TIMI 0, 3.7% (95% CI, 0.1-8.3); TIMI 1, 13.2% (5.7-20.7); TIMI 2, 17.1% (4.3-29.8); TIMI 3, 21.4% (4.4-38.4); TIMI 4, 20.0% (0.1-43.6); TIMI 5/6, 50.0% (0.1-100). CONCLUSIONS: The TIMI risk score has no clinically useful predictive value in patients with cocaine-associated chest pain.
Authors: Kristy Walsh; Anna Marie Chang; Jeanmarie Perrone; Christine McCusker; Frances Shofer; Mark Collin; Harold Litt; Judd Hollander Journal: J Med Toxicol Date: 2009-09
Authors: Guillermo Burillo-Putze; Beatriz López; Juan María Borreguero León; Miquel Sánchez Sánchez; Martin García González; Alberto Domínguez Rodriguez; Eva Vallbona Afonso; Alejandro Jiménez Sosa; Oscar Mirò Journal: Scand J Trauma Resusc Emerg Med Date: 2009-03-02 Impact factor: 2.953