Prognostic value of timi score versus grace score in st. Intensive statin is better than moderate statin post acs prove ittimi 22 3. The thrombolysis in myocardial infarction, or timi study group is an academic research organization aro affiliated with brigham and womens hospital and harvard medical school. Timi 9a and 9b were multicenter randomized trials evaluating the safety and efficacy of hirudin as an adjunct to fibrinolytic therapy tissue plasminogen activator or streptokinase at the physicians discretion. Event rates increased significantly as the timi risk score increased in the test cohort in timi 11b. Jun, 2010 use of the timi score to risk stratify acute coronary syndrome patients. The risk score was evaluated among 84 029 patients with stemi from the national registry of myocardial infarction 3 nrmi 3, which collected data on consecutive patients with myocardial infarction. Lukes please refer to the minnesota stemi guideline for further information, or if transferring to a pci hospital outside of duluth page 1 of 2 essentiast. Timi risk score for stelevation myocardial infarction.
Criteri di alto rischio per linfarto miocardico acuto con sopraslivellamento del tratto st in una strategia di rete. However, both the stemi and uanstemi timi risk scores were. Conclusionsthe timi risk score for stemi captures the majority of prognostic information offered by a full. The second timi tool for stemi patients, the risk index, was developed to provide a simple method of triaging patients with stemi on presentation. The pattern of increasing event rates with increasing timi risk score was confirmed in all 3 validation groups p. Risk stratification in acute coronary syndromesdoes the timi risk. Timi risk score in older adults with acute myocardial. Patients with st elevation acute myocardial infarction stemi comprise a he terogeneous population with respect to the risk for adverse. It is simple, low cost, easily applicable risk score using standard. The timi tools, whether the original version or the score for st elevation mi, along with this scoring method for non st elevation, help clinicians stratify patients at risk based on cardiovascular factors. This was a retrospective analysis of elderly 65 years female patients who underwent ppci for stelevated myocardial infarction stemi from.
Early routine vs late provisional use of eptifibatide iv gp iibiiia in nsteacs earlyacs 5. Application of the timi risk score for unstable angina and. Application of the timi risk score for stelevation mi in. Pdf patients with unstable anginanonstsegment elevation myocardial infarction mi uanstemi present with a wide spectrum of risk for death and. The parameters for the calculator include dm, history of htn or angina, systolic blood pressure, heart rate, killip class iiiv, body weight, anterior lead st elevation of left bbb, time to treat, age. Use of the timi score to risk stratify acute coronary syndrome patients. The timi study group has been an academic research organization dedicated to advancing the knowledge and care of patients suffering from cardiovascular disease. Pdf the timi risk score for unstable anginanonst elevation mi. Presenza di segni di scompenso classe killip 1 pressione arteriosa 100. External validation in the timi 9 trial showed similar prognostic capacity c statistic 0. The dynamic timi risk score for stemi was derived in extract timi 25 and validated in triton timi 38. Derivation and validation study derived from thrombolysis in myocardial infarction timi 11b trial and essence trials. The inhospital mortalities of patients with iabp support versus those without iabp support were 11.
The analysis included 897 patients with stemi either supported or not by an iabp. Dash stemi protocol for interhospital transfer duluth area stemi hospitals. Baseline variables were from the original timi risk score for stemi. Thrombolysis in myocardial infarction timi risk score.
The timi risk score at ed presentation successfully riskstrati. Stemi management reperfusion therapy reasonable for patients with stemi with symptom onset in prior 1224 hours if. The highest correlation of an individual timi risk indicator to adverse outcome was for. Overall, the timi risk score showed a strong potential of predicting mortality in stemi patients, revealing a significant, nearly 30fold graded increase in risk between patients with a score of.
The timi risk score for stemi predicts inhospital mortality and. Timi 28 and enoxaparin extract timi 25 as adjuncts to fibrinolysis for stemi 2. The parameters for the calculator include dm, history of htn or angina, systolic blood pressure, heart rate, killip class iiiv, body weight, anterior lead st. Conclusions in patients with uanstemi, the timi risk score is a simple prognos tication scheme that. Timi 28 and enoxaparin extracttimi 25 as adjuncts to fibrinolysis for stemi 2. It comprises of 7 factors that are evaluated through a simple questionnaire, each of the answers being given a certain amount of points.
Outcomes were timi risk score for developing at least 1 component of the primary end point allcause mortality, new or recurrent mi, or severe recurrent ischemia requiring urgent. Application of the timi risk score for stelevation mi in the. The prognostic discriminatory capacity of the timi score was comparable to that obtained in the full multivariable model c statistic 0. Timi 3 flow 5060% efficacy in patients presenting with chf or shock accaha. The group has its headquarters in boston, massachusetts, and a satellite location in quincy the timi study group was founded by eugene braunwald, md in 1984. Timi risk score for secondary prevention trs 2p timi risk score for hf in diabetes trshfdm bmi. The timi risk score for unstable anginanonst elevation mi. Comparison of the grace, heart and timi score to predict. Timi risk score11 has been validated and can be used. A timi risk score of 0 or 1 does not equal zero risk of adverse outcome. The cstatistics predictive value of the timi risk score for mortality was 0. Original article inhospital outcome of acute stsegment. Although there are multiple methods of risk stratification for st.
Clinical andor ecg evidence of ongoing ischemia first line. Ems preactivated yes no emergency department to complete onset chest pain time ed arrival time ecg time means of transport to ed selffamily ambulance call to sjmc time receiving cardiologist. Between timi and grace scores, identify the one of better prognostic performance in patients with stemi. Performance of the timi risk score in predicting mortality after. Timi risk score predicts death in stemi patients medscape. The timi score showed equal distribution of patients in the ranges of low, intermediate and high risk 39 %, 27 % and 34 %, respectively, as opposed to the grace score that showed predominant distribution at low risk 80 %, % and 7%, respectively. Timi risk score for stemi was created as the simple arithmetic sum of independent predictors of mortality weighted according to the adjusted odds ratios from logistic regression analysis in the intravenous npa for treatment of infarcting myocardium early ii trial n514 114. Seven of 12 characteristics significantly predicted adverse outcome. Mode of admission and its effect on quality indicators in. The timi risk score for unstable anginanonst evelation mi.
Application of the timi risk score for stelevation mi in the national. Timi risk score for secondary prevention trs 2p risk in patients with known atherosclerotic vascular disease chf htn age 75 dm prior stroke prior cabg pad egfr 60 current smoking. The following table introduces the seven items in this cardiac risk score. Creatinine clearance cockcroft gault equation gfr calculators. The timi risk score for unstable anginanonst elevation. The timi score for stsegment elevation myocardial infarction stemi was created and validated specifically for this clinical scenario, while. The timi risk score is a valid tool for risk stratification in unselected cases. When a patient presents with an acute stemi, the optimal treatment is usually clear proceed to pci immediately. This is a pdf file of an unedited manuscript that has.
The calculator thrombolysis in myocardial infarction timi score for st elevation acute myocardial infarction is used as a simple arithmetic sum of independent predictors of mortality. Fmcdevice time 120 mins doorneedle time timi score for st elevation acute myocardial infarction is used as a simple arithmetic sum of independent predictors of mortality. The timi risk score for stemi is also useful for patients with known stemi. Though these patients have a clear protocol normally thrombolysis or percutaneous coronary intervention and are already high risk for mortality, the timi risk score for stemi provide risk stratification which helps treatment decisions after acute issues have been.
Unclear if this risk score can be used in patients with. The timi risk score for stemi was assessed in an external data set from the timi 9 trial. Reynolds cad risk timi risk score stemi valiant heart failure risk score grace the grace acs risk calculator estimates risk of death following acute coronary syndrome acs pretest probability of cad cad consortium determine pretest probability of coronary artery disease in patients with chest pain. The timi score for stsegment elevation myocardial infarction stemi was created and validated specifically for this clinical scenario, while the grace score is generic to any type of acute coronary syndrome. Ems preactivated yes no emergency department to complete onset chest pain time ed arrival time ecg time. Intensive statin is better than moderate statin post acs prove it timi 22 3. Thrombolysis in myocardial infarction timi risk score was developed from multicenter international randomized clinical trials on patients with nstemi and ua, and it has been validated in nonselected western patient populations. Presenza di segni di scompenso classe killip 1 pressione arteriosa 100 bmin eta avanzata 75 anni.
A method for prognostication and therapeutic decision making. The management of patients with an acute coronary syndrome acs requires accurate risk. In order to provide the result, this timi risk score for nstemi calculator sums the points and delivers a mortality risk percentage. The prognostic performance of the risk score was stable over multiple time points 1 to 365 days. Contextthe thrombolysis in myocardial infarction timi risk score for st elevation myocardial infarction stemi is a simple integer score for. Thrombolysis in myocardial infarction timi score for stemi. Timi risk score for ua and non stemi antman em et al. Patient data sheet ed physician family cell phone ed phone. Prognostic value of timi score versus grace score in stsegment. Prasugrel in acs treated with pci triton timi 38 4.
A timi score timi score in general, patients having multiple coronary risk factors, advanced age, rest angina, clinical left ventricular lv dysfunction, prior history of percutaneous coronary intervention. The dynamic timi risk score for stemi was derived in extracttimi 25 and validated in tritontimi 38. In triton timi 38, patients with moderate to highrisk acs 74% nsteacs undergoing pci treated with a p2y12 inhibitor x 14. Pdf dynamic timi risk score for stemi researchgate.
This risk assessment model is recommended in the triage and management of patients with stemi who are eligible for fibrinolytic treatment. Timi 9a and 9b were multicenter randomized trials evaluating the safety and efficacy of hirudin as an adjunct to fibrinolytic therapy tissue plasminogen activator or. Garcia et al reported low timi score 02 among 41% patients, moderate score 34 among 44% patients and high score 57 among 15% of their patients. To validate the timi risk score in a population of stemi patients reflective of contemporary practice. Prasugrel effient vs clopidogrel plavix in patients with acs 1 trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel thrombolysis in myocardial infarction.
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