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TIMI Risk Score accurately predicts risk of death in 30-day and one-year follow-up in STEMI patients treated with primary percutaneous coronary interventions.
Kardiol Pol. 2007 Jul; 65(7):788-95; discussion 796-7.KP

Abstract

BACKGROUND

TIMI Risk Score for ST-elevation myocardial infarction (STEMI) was developed in a cohort of patients treated with fibrinolysis. It was though to predict in-hospital and short-term prognosis. Later studies validated this approach in large cohorts of patients, regardless of the applied treatment and presented its good power to predict 30-day mortality.

AIM

We applied the TIMI Risk Score to our registry of STEMI patients treated with primary percutaneous intervention (pPCI) to validate the possibility to predict one-year survival.

METHODS

Our registry comprised 494 consecutive patients (mean age 58.5+/-11.3 years) with STEMI treated with pPCI who were followed for approximately one year. STEMI was diagnosed based on typical criteria: chest pain, ECG changes and rise in myocardial necrosis markers. In all patients TIMI Risk Score for STEMI was calculated and they were divided into three groups: low risk (0-5 points), medium risk (6-7) and high risk (>7 points). Multivariate logistic regression analysis, Kaplan-Meier survival analysis with Cox and log-rank tests as well as c statistics from receiver-operator curves (ROC) were used for statistical analysis.

RESULTS

TIMI 3 flow was obtained in 95.5% of patients. Median TIMI risk score was 4 (ranging from 0 to 10). During follow-up there were 47 deaths (9.5%). There was a statistically significant difference in survival between all risk groups both in 30-day and one-year follow-up (p <0.001 log-rank test). TIMI Risk Score had good power to predict 30-day (c statistic 0.834, 95% CI 0.757-0.91, p <0.0001) as well as one-year mortality (c statistic 0.809, 95% CI 0.739-0.878, p <0.0001). Interestingly, when we excluded from the analysis all patients who died during the first 30 days, TIMI Risk score maintained its very good prognostic value. All analysed risk groups significantly differed between each other with respect to mortality (p <0.05, log-rank test) and the c statistic was 0.745 (95% CI 0.612-0.879, p <0.0002). In multivariate logistic regression analysis TIMI Risk Score was one of the independent risk factors of death during one-year follow-up (OR 1.59, p <0.001).

CONCLUSIONS

TIMI Risk Score accurately defines the population of STEMI patients who are at high risk of death not only during the first 30 days, but also during a long-term follow-up. This simple score should be included in the discharge letters because it contains very useful information for further care.

Authors+Show Affiliations

Klinika Kardiologii, Akademia Medyczna, ul. M. Skłodowskiej-Curie 24a, 15-276 Białystok. fizklin@mp.plNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17694460

Citation

Kozieradzka, Anna, et al. "TIMI Risk Score Accurately Predicts Risk of Death in 30-day and One-year Follow-up in STEMI Patients Treated With Primary Percutaneous Coronary Interventions." Kardiologia Polska, vol. 65, no. 7, 2007, pp. 788-95; discussion 796-7.
Kozieradzka A, Kamiński K, Dobrzycki S, et al. TIMI Risk Score accurately predicts risk of death in 30-day and one-year follow-up in STEMI patients treated with primary percutaneous coronary interventions. Kardiol Pol. 2007;65(7):788-95; discussion 796-7.
Kozieradzka, A., Kamiński, K., Dobrzycki, S., Nowak, K., & Musiał, W. (2007). TIMI Risk Score accurately predicts risk of death in 30-day and one-year follow-up in STEMI patients treated with primary percutaneous coronary interventions. Kardiologia Polska, 65(7), 788-95; discussion 796-7.
Kozieradzka A, et al. TIMI Risk Score Accurately Predicts Risk of Death in 30-day and One-year Follow-up in STEMI Patients Treated With Primary Percutaneous Coronary Interventions. Kardiol Pol. 2007;65(7):788-95; discussion 796-7. PubMed PMID: 17694460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - TIMI Risk Score accurately predicts risk of death in 30-day and one-year follow-up in STEMI patients treated with primary percutaneous coronary interventions. AU - Kozieradzka,Anna, AU - Kamiński,Karol, AU - Dobrzycki,Sławomir, AU - Nowak,Konrad, AU - Musiał,Włodzimierz, PY - 2007/8/19/pubmed PY - 2007/12/6/medline PY - 2007/8/19/entrez SP - 788-95; discussion 796-7 JF - Kardiologia polska JO - Kardiol Pol VL - 65 IS - 7 N2 - BACKGROUND: TIMI Risk Score for ST-elevation myocardial infarction (STEMI) was developed in a cohort of patients treated with fibrinolysis. It was though to predict in-hospital and short-term prognosis. Later studies validated this approach in large cohorts of patients, regardless of the applied treatment and presented its good power to predict 30-day mortality. AIM: We applied the TIMI Risk Score to our registry of STEMI patients treated with primary percutaneous intervention (pPCI) to validate the possibility to predict one-year survival. METHODS: Our registry comprised 494 consecutive patients (mean age 58.5+/-11.3 years) with STEMI treated with pPCI who were followed for approximately one year. STEMI was diagnosed based on typical criteria: chest pain, ECG changes and rise in myocardial necrosis markers. In all patients TIMI Risk Score for STEMI was calculated and they were divided into three groups: low risk (0-5 points), medium risk (6-7) and high risk (>7 points). Multivariate logistic regression analysis, Kaplan-Meier survival analysis with Cox and log-rank tests as well as c statistics from receiver-operator curves (ROC) were used for statistical analysis. RESULTS: TIMI 3 flow was obtained in 95.5% of patients. Median TIMI risk score was 4 (ranging from 0 to 10). During follow-up there were 47 deaths (9.5%). There was a statistically significant difference in survival between all risk groups both in 30-day and one-year follow-up (p <0.001 log-rank test). TIMI Risk Score had good power to predict 30-day (c statistic 0.834, 95% CI 0.757-0.91, p <0.0001) as well as one-year mortality (c statistic 0.809, 95% CI 0.739-0.878, p <0.0001). Interestingly, when we excluded from the analysis all patients who died during the first 30 days, TIMI Risk score maintained its very good prognostic value. All analysed risk groups significantly differed between each other with respect to mortality (p <0.05, log-rank test) and the c statistic was 0.745 (95% CI 0.612-0.879, p <0.0002). In multivariate logistic regression analysis TIMI Risk Score was one of the independent risk factors of death during one-year follow-up (OR 1.59, p <0.001). CONCLUSIONS: TIMI Risk Score accurately defines the population of STEMI patients who are at high risk of death not only during the first 30 days, but also during a long-term follow-up. This simple score should be included in the discharge letters because it contains very useful information for further care. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/17694460/TIMI_Risk_Score_accurately_predicts_risk_of_death_in_30_day_and_one_year_follow_up_in_STEMI_patients_treated_with_primary_percutaneous_coronary_interventions_ L2 - https://medlineplus.gov/heartattack.html DB - PRIME DP - Unbound Medicine ER -