Acute coronary syndrome acs and the timi risk score. Data on longterm secondary atherothrombotic risk stratification are limited. The timi risk score for stemi predicts inhospital mortality and. Symptoms suggestive of acs noncardiac diagnosis chronic stable. We used data from 3,609 stemi patients undergoing ppci in a high. The thrombolysis in myocardial infarction timi risk score for stemi was created as the simple arithmetic sum of independent predictors of. The dynamic timi risk score estimates the risk of mortality at 1 year in stemi. It provides information to both patients and clinicians on the possible prognosis and serves as a guide to aggressiveness of treatment. The timi risk score for stemi was assessed in an external data set from the timi 9 trial.
The timi risk score for uanstemi can be used to help risk. Application of the timi risk score for stelevation mi in. A timi risk score of 0 or 1 does not equal zero risk of adverse outcome. Acute coronary syndrome, nstemi, risk scores, risk stratification, unstable. Risk stratification in patients with coronary artery disease. Stemi extensive anterior wall onset 4 hours killip i timi score. The timi risk score at ed presentation successfully risk strati. Pdf an asian validation of the timi risk score for st. Application of the timi risk score for unstable angina and. An asian validation of the timi risk score for stsegment elevation myocardial infarction.
The timi risk score for unstable anginanonst elevation mi. I in patients with uanstemi, this timi risk score is a simple prognostication scheme that categorizes the risk of death and ischemic events and provides a basis for therapeutic decision making. 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 thrombolysis in myocardial infarction timi risk score incorporates eight variables obtained from the history, physical examination, and ecg table 1. N refers to the number of patients falling under that score. The highest correlation of an individual timi risk. Risk score may allow for discharge of stemi patients. Reynolds cad risk timi risk score stemi valiant heart failure risk score grace the grace acs risk calculator estimates risk of death following acute coronary syndrome acs pretest probability of. A simple score for the prediction of stent thrombosis in. Background patients who survive nonstelevation myocardial infarction nstemi are at heightened risk of recurrent cardiovascular events. Conclusions in the expanded jac registry, a higher proportion of patients with stemi. Risk stratification is important in acute coronary syndromes acs. Timi risk can be calculated on the timi website under clinical calculators. Timi risk score for secondary prevention of recurrent.
In patients treated with fibrinolysis, a timi score of 9 or greater predicts a 30day mortality of approximately 35%. Pubmed was systematically searched for acs risk score studies. It comprises of 7 factors that are evaluated through a simple questionnaire, each of the answers being given a certain amount of points. A method for prognostication and therapeutic decision making. I the thrombolysis in myocardial infarction timi risk score for stelevation myocardial infarction stemi is a 8 items scoring system developed to predict the risk of death from any cause at 30 days in patients with stemi. Patient or physician preference in the absence of high risk. Pdf acute coronary syndromes acs represent a difficult challenge for physicians. Here, we compared inhospital mortality and predictive performance of the time risk score. Risk score may allow for discharge of stemi patients a simpletouse risk score can identify low risk patients following a stelevation myocardial infarction and may provide an opportunity to employ early. Pdf the timi risk score for stemi predicts inhospital mortality. Pdf dynamic timi risk score for stemi researchgate. The maximum possible risk score is 14 points and the minimum 0. Developed and validated in multiple clinical trials of fibrinolysis, the risk score.
Objectives to stratify postnstemi patients for risk of recurrent cardiovascular events to maximise benefit from aggressive secondary prevention strategies using the timi risk. 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. It is a tool that differentiates nonstemi from stemi ischemic events. Application of the timi risk score for stelevation mi in the national.
Timi risk score for stelevation myocardial infarction. Timi risk score11 has been validated and can be used. An asian validation of the timi risk score for stsegment. Stemi assistant is a condensed 42 page reference manual for health care practitioners who care for patients experiencing acute st segment elevation myocardial infarction stemi. Dynamic timi risk score for stemi for predicting 1.
The use of risk scores for stratification of nonst elevation acute. Traditionally, the timi risk score for uanstemi can correlate the risk of adverse outcome in chest pain patients. The timi risk score evaluates risk of ischemic events and mortality in patients diagnosed with st elevation myocardial infarction based on clinical data such as systolic blood pressure, killip class or history of diabetes. Stemi extensive anterior wall onset 4 hours killip i timi. Conclusionsthe timi risk score for stemi captures the majority of prognostic information offered by a full logistic regression model but is more. Does simplicity compromise accuracy in acs risk prediction. Unclear if this risk score can be used in patients with. The timi risk score for unstable anginanonst elevation. Contextthe thrombolysis in myocardial infarction timi risk score for st elevation myocardial infarction stemi is a simple integer score for.
The dynamic timi risk score has a high discriminatory capacity, with a c. Patients with stemi are generally considered at risk for ischemic complications. The timi risk score for uanstemi estimates mortality for patients with unstable angina and nonst elevation myocardial infarction mi. Timi 9a and 9b were multicenter randomized trials evaluating the safety and efficacy of hirudin as an adjunct to. Pdf timi, grace and alternative risk scores in acute coronary. Acs risk stratification is presented, and features the heart score. Gender, timi risk score and inhospital mortality in stemi. A timi score risk and a timi score in general, patients having multiple coronary risk factors, advanced age, rest angina. Mortality increased significantly with timi risk score in patient with timi score timi score. The present study aimed to evaluate the potential utility of thrombosis in myocardial infarction timi risk index tri for the prediction of stent thrombosis st in st elevation myocardial infarction stemi. Event rates increased significantly as the timi risk score increased in the test cohort in timi 11b. It was concluded that in patients with uanstemi, the timi risk score can facilitate decision making and stratify mortality risk.
In patients transferred for primary pci, timi risk score. Patients with st elevation acute myocardial infarction stemi comprise a heterogeneous population with respect to the risk for. Context the thrombolysis in myocardial infarction timi risk score for stelevation myocardial infarction stemi is a simple integer score for bedside risk assessment of patients with stemi. Risk scores after acute coronary syndrome genovefa d. A randomized trial of transfer for primary angioplasty versus on site. Thrombolysis in myocardial infarction timi score for.
In order to provide the result, this timi risk score for nstemi calculator sums the points and delivers a mortality risk. Patients with st elevation acute myocardial infarction stemi comprise a he terogeneous population with respect to the risk for adverse events. This score was developed based on thrombolytic outcomes, which likely have worse outcomes when compared to pci. The timi risk score for stemi may help a cardiology, medical andor intensive care team with weighing risk benefit of medications like anticoagulation and invasive procedures by knowing a patients baseline risk. Timi risk score for stemi historical age 6574 2 points 75 3 points dmhtn or 1 point angina exam sbp 100 2 points killip iiiv 2 points weight 4 hrs risk score. The identification and acute management of stemi is rarely a conundrum. The timi uanstemi risk score range 07 was derived from a cohort of the timi 11b clinical trial for a composite endpoint of mortality, recurrent mi, and repeat revascularization. Event rates increased significantly as the timi risk score increased in the test cohort in timi 11b and this pattern of increase was confirmed in the validation cohorts. External validation in the timi 9 trial showed similar prognostic capacity c statistic 0.
Predictors of the thrombolysis in myocardial infarction timi risk score for. Stemi extensive anterior wall onset 4 hours killip i timi score 314 free download as powerpoint presentation. Youll probably see that for timi scores of 0 and 1, theres about a 5% risk and for timi of 2, theres an 8% risk. Timi risk score for stemi free pdf download this is a pdf document titled timi risk score for stemi. Whereas the baseline timi risk score for stemi has 0 to 14 possible points, the dynamic timi risk score has a total of 0 to 29 possible points, with 0 to 15 points assigned based on in. Background the thrombolysis in myocardial infarction timi risk scores for unstable anginanonstelevation myocardial infarction uanstemi and stelevation myocardial infarction stemi and the global registry of acute coronary events grace risk scores for inhospital and 6month mortality are established tools for assessing risk. The thrombolysis in myocardial infarction timi risk score for stelevation myocardial infarction stemi is a simple integer score for bedside risk assessment of patients with stemi. Coronary artery disease, risk score, risk assessment, coronary artery bypass. Timi risk score for stemi risk score odds of death by. Characteristics, treatment and inhospital outcomes of. The prognostic performance of the risk score was stable over multiple time points 1 to 365 days.