Document Detail


Modified thrombolysis in myocardial infarction (TIMI) risk score to risk stratify patients in the emergency department with possible acute coronary syndrome.
MedLine Citation:
PMID:  17318424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the prognostic utility of the Thrombolysis in Myocardial Infarction (TIMI) risk score in patients in the emergency department (ED) evaluated for possible acute coronary syndrome (ACS). BACKGROUND: The ability of the TIMI risk score to risk stratify patients at initial presentation in the ED with chest pain of unclear etiology is uncertain. METHODS: We investigated the prognostic utility of the TIMI risk score in 947 consecutive patients evaluated in the ED for possible ACS. A multivariate analysis was done to evaluate the independent predictive power of the individual components of the TIMI risk score to predict an adverse event at 30 days (all-cause death, myocardial infarction, and coronary revascularization). RESULTS: There were 151 (16%) patients diagnosed with ACS. At 30 days there were 48 (5%) deaths, 84 (9%) myocardial infarctions, and 49 (5%) coronary revascularization procedures. The mean TIMI risk score was significantly higher in patients with an adverse event compared with those without (2.6 +/- 1.3 vs. 1.7 +/- 1.2, P < 0.0001). Four of the 7 TIMI risk factors (age > or = 65 years, ST segment deviation > or = 0.5 mm elevated troponin I, and coronary stenosis > or = 50%) were independently associated with adverse events. A simplified TIMI risk score was computed and was found to have similar prognostic ability as the 7 variable TIMI risk score. CONCLUSION: A modified TIMI risk score may simplify risk stratification of ED patients with undifferentiated chest pain.
Authors:
Zehra Jaffery; Michael P Hudson; Gordon Jacobsen; Richard Nowak; James McCord
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2007-02-21
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  24     ISSN:  0929-5305     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-08-03     Completed Date:  2007-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  137-44     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA. zjaffer1@hfhs.org
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis*,  drug therapy
Aged
Chest Pain
Coronary Stenosis
Death
Emergency Service, Hospital*
Female
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / diagnosis*,  drug therapy*
Myocardial Revascularization
Predictive Value of Tests*
Prognosis
Risk Assessment
Risk Factors
Thrombolytic Therapy / methods*
Troponin I / blood
Chemical
Reg. No./Substance:
0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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