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The TIMI risk score for STEMI predicts in-hospital mortality and adverse events in patients without cardiogenic shock undergoing primary angioplasty.
MedLine Citation:
PMID:  22452860     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction: Patients with ST elevation acute myocardial infarction (STEMI) comprise a heterogeneous population with respect to the risk for adverse events. Primary percutaneous coronary intervention (PCI) has shown to be better, mainly in high-risk patients. Objective: The purpose of this study was to determine if the Thrombolysis in Myocardial Infarction (TIMI) risk score for STEMI applied to patients undergo primary PCI identifies a group of patients at high risk for adverse events. Methods: We identified patients with STEMI without cardiogenic shock on admission, who were treated with primary PCI. The TIMI and CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) risk scores were calculated to determine their predictive value for in hospital mortality. Patients were divided into two groups according to their TIMI riisk score, low risk being 0-4 points and high risk .5 points, and the frequency of adverse events was analyzed. Results: We analyzed 572 patients with STEMI. The c-statistics predictive value of the TIMI risk score for mortality was 0.80 (p=0.0001) and the CADILLAC risk score was 0.83, (p=0.0001). Thirty-two percent of patients classified as high risk (TIMI .5) had a higher incidence of adverse events than the low-risk group: mortality 14.8% vs. 2.1%, (p=0.0001); heart failure 15.3% vs. 4.1%, (p=0.0001); development of cardiogenic shock 10.9% vs. 1.5%, (p=0.0001); ventricular arrhythmias 14.8% vs. 5.9%, (p=0.001); and no-reflow phenomenon 22.4% vs. 13.6%, (p=0.01). Conclusions: The TIMI risk score for STEMI prior to primary PCI can predict in hospital mortality and identifies a group of high-risk patients who might develop adverse events.
Authors:
Héctor González-Pacheco; Alexandra Arias-Mendoza; Amada Alvarez-Sangabriel; Ursulo Juárez-Herrera; Félix Damas; Guering Eid-Lidt; Francisco Azar-Manzur; Carlos Martínez-Sánchez
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Archivos de cardiologia de Mexico     Volume:  82     ISSN:  1405-9940     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-3-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101126728     Medline TA:  Arch Cardiol Mex     Country:  -    
Other Details:
Languages:  ENG     Pagination:  7-13     Citation Subset:  -    
Affiliation:
Coronary Care Unit. Instituto Nacional de Cardiología Ignacio Chávez. Mexico City. Mexico.
Vernacular Title:
La escala de riesgo TIMI para infarto del miocardio con elevación del segmento ST predice mortalidad y eventos adversos intrahospitalarios en pacientes sin choque cardiogénico sometidos a angioplastía coronaria.
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