Document Detail


Relation between thrombolysis in myocardial infarction risk score and one-year outcomes for patients presenting at the emergency department with potential acute coronary syndrome.
MedLine Citation:
PMID:  20152236     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Thrombolysis in Myocardial Infarction (TIMI) score, derived from unstable angina/non-ST-segment elevation acute myocardial infarction patient population, predicts 14-day cardiovascular events. It has been validated in emergency department (ED) patients with potential acute coronary syndrome with respect to 30-day outcomes. Our objective was to determine whether the initial TIMI score could risk stratify ED patients with potential acute coronary syndrome with respect to the 1-year outcomes. This was a prospective cohort study of patients presenting to the ED with chest pain who underwent electrocardiography. Patients with ST-segment elevation myocardial infarction (acute myocardial infarction) were excluded. Follow-up was conducted by telephone and record review >1 year after the index visit. The main outcome was the 1-year mortality, nonfatal acute myocardial infarction, or revascularization stratified by the TIMI score. Of 2,819 patients, 253 (9%) met the composite outcome. The overall incidence of the composite 1-year outcome of death (n = 119), acute myocardial infarction (n = 96), and revascularization (n = 90) according to TIMI score was TIMI 0 (n = 1,162), 4%; TIMI 1 (n = 901), 8%; TIMI 2 (n = 495), 13%; TIMI 3 (n = 193), 23%; TIMI 4 (n = 60), 28%; and TIMI 5 to 7 (n = 8), 88% (p <0.001). In conclusion, in addition to risk stratifying ED patients with chest pain at the initial ED evaluation, the TIMI score can also predict the 1-year cardiovascular events in this patient population.
Authors:
Benjamin M Weisenthal; Anna Marie Chang; Kristy M Walsh; Mark J Collin; Frances S Shofer; Judd E Hollander
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Publication Detail:
Type:  Journal Article     Date:  2010-01-05
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-15     Completed Date:  2010-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA. benjam@sas.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / diagnosis*,  drug therapy,  mortality*
Adult
Aged
Biological Markers / metabolism
Chest Pain / etiology
Cohort Studies
Electrocardiography
Emergency Service, Hospital*
Female
Follow-Up Studies
Hospitals, University
Humans
Incidence
Male
Middle Aged
Myocardial Infarction / diagnosis*,  drug therapy,  mortality*
Myocardial Revascularization
Philadelphia / epidemiology
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Survival Rate
Thrombolytic Therapy*
Chemical
Reg. No./Substance:
0/Biological Markers

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