![]() 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. Comparison of the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients at the emergency department. ![]() The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making JAMA. Age 18-15 and either 3 cardiac risk factors or known coronary artery disease (previous acute MI, coronary artery bypass graft, or percutaneous coronary. 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 All rights reserved.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 Physician in the emergency department should be aware of the importance of clinical examination in the risk stratification in patients presenting with ACS.Ĭopyright © 2012 Elsevier Inc. High Killip class was independent predictors of mortality in ST-elevation myocardial infarction and non-ST-elevation acute coronary syndrome. In conclusion, across ACS, patients with higher Killip class had worse clinical profile and were less likely to be treated with evidence-based therapy. Classes II, III, and IV were associated with higher adjusted odds of death in ST-elevation myocardial infarction (odds ratio 2.1, 95% confidence interval 1.25-3.69 OR 6.1, 95% CI 3.41-10.86 and OR 28, 95% CI 15.24-54.70, respectively) and non-ST-elevation acute coronary syndrome (adjusted OR 2.4, 95% CI 1.24-4.82 OR 3.2,95% 1.49-7.02 and OR 9.8, 95% CI 3.79-25.57, respectively). In comparison to Killip Class I, patients with higher Killip class had greater prevalence of cardiovascular risk factors, presented late, were less likely to have angina, and were less likely to receive antiplatelet, statins, and β-blockers. High Killip classes were defined in 22% of patients. Patients' characteristics and in-hospital outcomes were analyzed. Patients were categorized according to Killip classification at presentation (Classes I, II, III, and IV). In 2007 and over 5 months, 6704 consecutive patients with ACS were enrolled in the Gulf Registry of Acute Coronary Events. ![]() ![]() The purpose of this study was to assess the prognostic value of the Killip classification at the presentation in patients with acute coronary syndrome (ACS). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |