| Thrombolysis in Myocardial Infarction (TIMI) Risk Index predicts long-term mortality and heart failure in patients with ST-elevation myocardial infarction in the TIMI 2 clinical trial. | |
| | |
MedLine Citation:
|
PMID: 19332194 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: TIMI (Thrombolysis in Myocardial Infarction) Risk Index (TRI) is a simple bedside score that predicts 30-day mortality in patients with ST-elevation myocardial infarction (MI). We sought to evaluate whether TRI was predictive of long-term mortality and clinical events. METHODS: In the TIMI 2 trial, 3,153 patients (mean age 57 +/- 10 years, 82% men) were randomized to invasive (n = 1,583) versus conservative (n = 1,570) strategy postfibrinolysis with median follow-up of 3 years. TIMI Risk Index was divided into 5 groups. The primary end point was all-cause mortality. Secondary analyses included recurrent MI, congestive heart failure (CHF), and combined end points. RESULTS: When compared with group 1, mortality in group 5 was more than 5-fold higher (hazard ratio [HR] 5.83, P < .0001) and was also increased in group 4 (HR 2.80, P < .0001) and group 3 (HR 1.96, P = .002) (c statistic 0.69). No difference was seen between groups 1 and 2 (P = .74). A similar increasing gradient effect was seen across TRI strata with group 5 having the highest risk for CHF (HR 4.13, P < .0001) and the highest risk for composite death/CHF (HR 4.35, P < .0001) over group 1. There was no difference in recurrent MI between the groups (P = .22). After controlling for other risk indicators, the relationship between TRI and mortality remained significant: group 5, HR 4.11, P < .0001; group 4, HR 2.14, P = .0009; group 3, HR 1.69, P = .02. When stratified by TRI groups, no differences in mortality or composite death/MI were found between treatment strategies. CONCLUSIONS: The simple TRI can predict increased long-term mortality, CHF, and composite death/CHF. |
| | |
Authors:
|
Quynh A Truong; Christopher P Cannon; Neil A Zakai; Ian S Rogers; Robert P Giugliano; Stephen D Wiviott; Carolyn H McCabe; David A Morrow; Eugene Braunwald |
Related Documents
:
|
20634484 - Gene delivery of sarcoplasmic reticulum calcium atpase inhibits ventricular remodeling ... 20032264 - Separate mechanisms cause anemia in ischemic vs. nonischemic murine heart failure. 22856344 - Regional lv deformation in healthy individuals during isovolumetric contraction and eje... 23174634 - A new score for risk stratification of patients with acute coronary syndromes undergoin... 11691504 - Increased intimal apoptosis in coronary atherosclerotic vessel segments lacking compens... 18718954 - Vena cava as autologous tissue for pulmonary valve substitute. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2009-02-23 |
Journal Detail:
|
Title: American heart journal Volume: 157 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-03-31 Completed Date: 2009-04-21 Revised Date: 2011-12-07 |
Medline Journal Info:
|
Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
|
Languages: eng Pagination: 673-9.e1 Citation Subset: AIM; IM |
Affiliation:
|
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Electrocardiography* Female Fibrinolytic Agents / therapeutic use* Follow-Up Studies Heart Failure / epidemiology*, etiology Humans Incidence Male Middle Aged Myocardial Infarction / complications, drug therapy*, mortality Prognosis Risk Factors Survival Rate / trends Thrombolytic Therapy / methods* Time Factors United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
|
K23 HL098370-03/HL/NHLBI NIH HHS; L30 HL093806-01/HL/NHLBI NIH HHS; L30HL093896/HL/NHLBI NIH HHS; T32 HL076136-05/HL/NHLBI NIH HHS; T32HL076136/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Fibrinolytic Agents |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Impact of stress testing before percutaneous coronary intervention or medical management on outcomes...
Next Document: Aldosterone and long-term outcome after myocardial infarction: A substudy of the french nationwide O...