![]() Subgroup analysis indicated early invasive strategy could significantly decrease the 30 d incidence of the combined end point events in patients with high TIMI risk score and the 6 months incidence of the combined end point events in patients with moderate and high TIMI risk score (all P < 0.01), but the incidence was similar between the two different strategies in patients with low TIMI risk score.Įarly invasive strategy may significantly reduce combined cardiovascular events in NSTE-ACS patients with moderate and high TIMI risk score compared with early conservative strategy. Rehospitalization due to recurrent ischemia angina of 30 days and the combined cardiovascular events of 30 days and 6 months were significantly lower in early invasive strategy group (3.5%, 10.0%, 21.1%) compared with early conservative strategy group (8.1%, 16.9%, 28.2%, all P < 0.05). The combined cardiovascular events (a combination of cardiac death, nonfatal myocardial infarction, nonfatal heart failure and re-hospital admission due to recurrent ischemia angina) within 30 days and 6 months were analyzed and related to the TIMI risk score at admission. 2003, 545 consecutive patients with NSTE-ACS were randomly assigned to early conservative strategy (n = 284) or early invasive strategy group (n = 261). 2012 59(23):2091-8.To investigate the relationship between thrombolysis in myocardial infarction (TIMI) risk score and efficacy of different treatment strategies in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS).įrom Oct. 2-Hour accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker: the ADAPT trial. Prospective validation of the thrombolysis in myocardial infarction risk score in the emergency department chest pain population. Ĭhase M, Robey JL, Zogby KE, Sease KL, Shofer FS, Hollander JE. Validation of the thrombolysis in myocardial infarction (TIMI) risk score for unstable angina pectoris and non-ST-elevation myocardial infarction in the TIMI III registry. Patients were stratified into low (TIMI score 2-4), and high risk (TIMI score 5-7, or presence of cardiogenic shock, ventricular fibrillation, or cardiac arrest). Scirica BM, Cannon CP, Antman EM, Murphy SA, Morrow DA, Sabatine MS, McCabe CH, Gibson CM, Braunwald E. We limited our study to patients undergoing early (<24 hr of the event onset), or late (24 hr) percutaneous coronary intervention (PCI). Application of the TIMI risk score for unstable angina and non-ST elevation acute coronary syndrome to an unselected emergency department chest pain population. Pollack CV, Sites FD, Shofer FS, Sease KL, Hollander JE. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making JAMA. Many guidelines recommend higher risk levels receiving more aggressive medical intervention and/or receiving early invasive management.Īntman EM, Cohen M, Bernink PJLM, McCabe CH, Hoacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E. If patients are in the 0 or 1 point group, they should be further risk stratified using another risk score or one’s own institutional practices, as risk is not low enough to safely discharge from the hospital. Newer chest pain risk scores such as the HEART Score have been shown to better stratify risk than the TIMI Score, particularly in the undifferentiated chest pain patient. Unclear if this risk score can be used in patients with chest pain in the setting of cocaine use. Originally derived with patients with known unstable angina or NSTEMI. TIMI Risk Score for unstable angina/NSTEMI was developed as one of the earliest chest pain decision rules that was widely implemented. Patients who have a higher risk score may require more aggressive medical or procedural intervention. TIMI Risk Score for ST-Elevation Myocardial Infarction: A Convenient, Bedside, Clinical Score for Risk Assessment at Presentation: An Intravenous nPA for. Patients with a score of 0 or 1 point are at lower risk of adverse outcome (death, MI, urgent revascularization) compared to patients with a higher risk score. Validation studies showed 1.7 to 2.1% of patients with a score of 0 still had adverse outcomes within 30 days. The original study showed 4.7% of patients with a score of 0 or 1 had adverse outcomes within 14 days. ScoreĪ TIMI risk score of 0 or 1 does not equal zero risk of adverse outcome. NB!!! A TIMI Risk Score of 0 does not equate to zero risk of adverse outcome. *Risk factors for CAD: Family history of CAD, hypertension, hypercholesterolemia, diabetes, or current smoker (thanks to Jeff Geske at Mayo for this update!) Interpretation of results: TIMI UA/NSTEMI assessment as addition of the selected points: Criteria Risk at 14 days of: all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization Hypertension, hypercholesterolemia, diabetes, family history of CAD, or current smoker:Ī TIMI Risk Score of 0 does not equate to zero risk of adverse outcome.ĭownload result as PDF file Patient’s score ![]()
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