BACKGROUND: Although the Thrombolysis In Myocardial Infarction (TIMI) score incorporates ST deviation, it does not account for characteristics of the ST deviations. In the present study, it was hypothesized that the magnitude and characteristics of ST deviation may add to the prognostic values of the TIMI risk score in acute coronary syndrome (ACS) patients, particularly in lower-risk patients with a TIMI risk score of less than 5. OBJECTIVE: To evaluate the prognostic value of combining the TIMI risk score and characteristics of ST deviation in patients with non-ST elevation ACS and a TIMI risk score of less than 5. METHODS: The death/myocardial infarction (MI) rates of 1296 patients enrolled in the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) angiographic substudy were examined. RESULTS: Patients without a TIMI risk score of 5 or greater, and without an ST deviation of 1 mm or greater had the lowest six-month rate of death/ MI (5%). In patients with a TIMI risk score of less than 5, the six-month death/MI rate was increased in those with ST depression of 2 mm or greater compared with patients with a similar TIMI risk score and without ST deviation of 1 mm or greater (24% versus 5%, P<0.001). The presence of ST deviation of 2 mm or greater identified an additional 15% of patients with an increased six-month death/MI rate in patients with a TIMI risk score of less than 5. CONCLUSION: ST segment deviation of 2 mm or greater confers additional prognostic information in non-ST elevation ACS patients with a TIMI risk score of less than 5. Patients with a TIMI risk score of less than 5 and ST deviation of 2 mm or less had the lowest risk of six-month death/MI.
BACKGROUND: Although the Thrombolysis In Myocardial Infarction (TIMI) score incorporates ST deviation, it does not account for characteristics of the ST deviations. In the present study, it was hypothesized that the magnitude and characteristics of ST deviation may add to the prognostic values of the TIMI risk score in acute coronary syndrome (ACS) patients, particularly in lower-risk patients with a TIMI risk score of less than 5. OBJECTIVE: To evaluate the prognostic value of combining the TIMI risk score and characteristics of ST deviation in patients with non-ST elevation ACS and a TIMI risk score of less than 5. METHODS: The death/myocardial infarction (MI) rates of 1296 patients enrolled in the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) angiographic substudy were examined. RESULTS:Patients without a TIMI risk score of 5 or greater, and without an ST deviation of 1 mm or greater had the lowest six-month rate of death/ MI (5%). In patients with a TIMI risk score of less than 5, the six-month death/MI rate was increased in those with ST depression of 2 mm or greater compared with patients with a similar TIMI risk score and without ST deviation of 1 mm or greater (24% versus 5%, P<0.001). The presence of ST deviation of 2 mm or greater identified an additional 15% of patients with an increased six-month death/MI rate in patients with a TIMI risk score of less than 5. CONCLUSION: ST segment deviation of 2 mm or greater confers additional prognostic information in non-ST elevation ACS patients with a TIMI risk score of less than 5. Patients with a TIMI risk score of less than 5 and ST deviation of 2 mm or less had the lowest risk of six-month death/MI.
Authors: Christian Mueller; Franz-Josef Neumann; Wolfgang Perach; André P Perruchoud; Heinz J Buettner Journal: Am J Med Date: 2004-08-01 Impact factor: 4.965
Authors: C P Cannon; C H McCabe; P H Stone; W J Rogers; M Schactman; B W Thompson; D J Pearce; D J Diver; C Kells; T Feldman; M Williams; R S Gibson; M W Kronenberg; L I Ganz; H V Anderson; E Braunwald Journal: J Am Coll Cardiol Date: 1997-07 Impact factor: 24.094
Authors: A Hersi; Y Fu; B Wong; K W Mahaffey; R A Harrington; R M Califf; F Van de Werf; P W Armstrong Journal: Eur Heart J Date: 2003-03 Impact factor: 29.983
Authors: Benjamin M Scirica; Christopher P Cannon; Elliott M Antman; Sabina A Murphy; David A Morrow; Marc S Sabatine; Carolyn H McCabe; C Michael Gibson; Eugene Braunwald Journal: Am J Cardiol Date: 2002-08-01 Impact factor: 2.778
Authors: Padma Kaul; L Kristin Newby; Yuling Fu; Vic Hasselblad; Kenneth W Mahaffey; Robert H Christenson; Robert A Harrington; E Magnus Ohman; Eric J Topol; Robert M Califf; Frans Van de Werf; Paul W Armstrong Journal: J Am Coll Cardiol Date: 2003-02-05 Impact factor: 24.094
Authors: E M Ohman; P W Armstrong; R H Christenson; C B Granger; H A Katus; C W Hamm; M A O'Hanesian; G S Wagner; N S Kleiman; F E Harrell; R M Califf; E J Topol Journal: N Engl J Med Date: 1996-10-31 Impact factor: 91.245
Authors: Marc S Sabatine; Carolyn H McCabe; David A Morrow; Robert P Giugliano; James A de Lemos; Marc Cohen; Elliott M Antman; Eugene Braunwald Journal: Am Heart J Date: 2002-06 Impact factor: 4.749
Authors: K L Lee; L H Woodlief; E J Topol; W D Weaver; A Betriu; J Col; M Simoons; P Aylward; F Van de Werf; R M Califf Journal: Circulation Date: 1995-03-15 Impact factor: 29.690
Authors: Patrizia Natale; Suetonia C Palmer; Valeria M Saglimbene; Marinella Ruospo; Mona Razavian; Jonathan C Craig; Meg J Jardine; Angela C Webster; Giovanni Fm Strippoli Journal: Cochrane Database Syst Rev Date: 2022-02-28