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An integrated clinical approach to predicting the benefit of tirofiban in non-ST elevation acute coronary syndromes. Application of the TIMI Risk Score for UA/NSTEMI in PRISM-PLUS.
Eur Heart J. 2002 Feb; 23(3):223-9.EH

Abstract

AIMS

We evaluated the TIMI Risk Score for Unstable Angina and Non-ST Elevation Myocardial Infarction for predicting clinical outcomes and the efficacy of tirofiban in non-ST elevation acute coronary syndromes.

METHODS AND RESULTS

Developed in TIMI 11B, the risk score is calculated as the sum of seven presenting characteristics (age > or =65 years, > or =3 cardiac risk factors, documented coronary disease, recent severe angina, ST deviation > or =0.5 mm, elevated cardiac markers, prior aspirin use). The risk score was validated in the PRISM-PLUS database (n=1915) and tested for interaction with the efficacy of tirofiban+heparin vs heparin alone. The risk score revealed an increasing gradient of risk for death, myocardial infarction or recurrent ischaemia at 14 days ranging from 7.7-30.5% (P<0.001). Dichotomized at the median, patients with a score > or =4 derived a greater relative risk reduction with tirofiban (P((Interaction))=0.025). Among patients with normal creatine kinase myocardial bands, the risk score showed a 3.5-fold gradient of risk (P<0.001) and identified a population that derived significant benefit from tirofiban (RR 0.73, P=0.027).

CONCLUSION

The TIMI Risk Score is a simple clinical tool for risk assessment that may aid in the early identification of patients who should be considered for treatment with potent antiplatelet therapy.

Authors+Show Affiliations

Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Evaluation Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

11792137

Citation

Morrow, D A., et al. "An Integrated Clinical Approach to Predicting the Benefit of Tirofiban in non-ST Elevation Acute Coronary Syndromes. Application of the TIMI Risk Score for UA/NSTEMI in PRISM-PLUS." European Heart Journal, vol. 23, no. 3, 2002, pp. 223-9.
Morrow DA, Antman EM, Snapinn SM, et al. An integrated clinical approach to predicting the benefit of tirofiban in non-ST elevation acute coronary syndromes. Application of the TIMI Risk Score for UA/NSTEMI in PRISM-PLUS. Eur Heart J. 2002;23(3):223-9.
Morrow, D. A., Antman, E. M., Snapinn, S. M., McCabe, C. H., Theroux, P., & Braunwald, E. (2002). An integrated clinical approach to predicting the benefit of tirofiban in non-ST elevation acute coronary syndromes. Application of the TIMI Risk Score for UA/NSTEMI in PRISM-PLUS. European Heart Journal, 23(3), 223-9.
Morrow DA, et al. An Integrated Clinical Approach to Predicting the Benefit of Tirofiban in non-ST Elevation Acute Coronary Syndromes. Application of the TIMI Risk Score for UA/NSTEMI in PRISM-PLUS. Eur Heart J. 2002;23(3):223-9. PubMed PMID: 11792137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An integrated clinical approach to predicting the benefit of tirofiban in non-ST elevation acute coronary syndromes. Application of the TIMI Risk Score for UA/NSTEMI in PRISM-PLUS. AU - Morrow,D A, AU - Antman,E M, AU - Snapinn,S M, AU - McCabe,C H, AU - Theroux,P, AU - Braunwald,E, PY - 2002/1/17/pubmed PY - 2002/5/2/medline PY - 2002/1/17/entrez SP - 223 EP - 9 JF - European heart journal JO - Eur Heart J VL - 23 IS - 3 N2 - AIMS: We evaluated the TIMI Risk Score for Unstable Angina and Non-ST Elevation Myocardial Infarction for predicting clinical outcomes and the efficacy of tirofiban in non-ST elevation acute coronary syndromes. METHODS AND RESULTS: Developed in TIMI 11B, the risk score is calculated as the sum of seven presenting characteristics (age > or =65 years, > or =3 cardiac risk factors, documented coronary disease, recent severe angina, ST deviation > or =0.5 mm, elevated cardiac markers, prior aspirin use). The risk score was validated in the PRISM-PLUS database (n=1915) and tested for interaction with the efficacy of tirofiban+heparin vs heparin alone. The risk score revealed an increasing gradient of risk for death, myocardial infarction or recurrent ischaemia at 14 days ranging from 7.7-30.5% (P<0.001). Dichotomized at the median, patients with a score > or =4 derived a greater relative risk reduction with tirofiban (P((Interaction))=0.025). Among patients with normal creatine kinase myocardial bands, the risk score showed a 3.5-fold gradient of risk (P<0.001) and identified a population that derived significant benefit from tirofiban (RR 0.73, P=0.027). CONCLUSION: The TIMI Risk Score is a simple clinical tool for risk assessment that may aid in the early identification of patients who should be considered for treatment with potent antiplatelet therapy. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/11792137/An_integrated_clinical_approach_to_predicting_the_benefit_of_tirofiban_in_non_ST_elevation_acute_coronary_syndromes__Application_of_the_TIMI_Risk_Score_for_UA/NSTEMI_in_PRISM_PLUS_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1053/euhj.2001.2738 DB - PRIME DP - Unbound Medicine ER -