![]() High risk patients received thrombolytic less frequently than the patients at low risk. There was a progressive increase in mortality and incidence of in-hospital complications according to the stratification by the TIMI score. The chance of receiving fibrinolytic was 50% lower in the high-risk group in relation to the low risk group (95% CI = 0.27 to 0.85, p = 0.004). The risk of death in cases of high risk was 14.1 times higher than in the cases of medium and low risk (95% CI = 4.4 to 44.1 and p <0.001). The mortality was 8.1% in the medium risk group and 55.6% in the high-risk group. In the low-risk group there was no death. The hospital mortality after infarction was 17.5%. The cases were analyzed in three risk groups according to the TIMI score. We evaluated, retrospectively, 103 cases of acute myocardial infarction with ST-segment elevation admitted to the Hospital Nossa Senhora da Conceição - Tubarão, in 20. To evaluate the management and clinical evolution of hospital inpatients with acute myocardial infarction, according to risk stratification by the TIMI score. As the risk profiles of these cases differ from those found in non-selected populations, it is important to review the applicability of the score in usual clinical conditions. The TIMI (Thrombolysis In Myocardial Infarction) Risk Score for Secondary Prevention (TRS 2P) is a simple 9-point risk stratification tool, previously developed in a large population with atherothrombosis to predict CV death, myocardial infarction (MI), and ischemic stroke (CV death/MI/ischemic cerebrovascular accident iCVA). 2012 59(23):2091-8.The TIMI (Thrombolysis in Myocardial Infarction) risk score is derived from clinical trial involving patients who are eligible for fibrinolysis. 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. Scirica BM, Cannon CP, Antman EM, Murphy SA, Morrow DA, Sabatine MS, McCabe CH, Gibson CM, Braunwald E. 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. ![]() ![]() 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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