![]() ![]() This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: The present work was supported in part by unrestricted grants from: Sanofiaventis, Pfizer, the Blue Cross Blue Shield Foundation, the Mardigian Foundation, and the University of Michigan Health System. Received: SeptemAccepted: OctoPublished: November 23, 2009Ĭopyright: © 2009 Aragam et al. Hernandez, Lerner Research Institute, Cleveland Clinic, United States of America (2009) Does Simplicity Compromise Accuracy in ACS Risk Prediction? A Retrospective Analysis of the TIMI and GRACE Risk Scores. Study limitations included unaccounted for confounders inherent to observational, single institution studies with moderate sample sizes.Ĭitation: Aragam KG, Tamhane UU, Kline-Rogers E, Li J, Fox KAA, Goodman SG, et al. An analysis of refitted multivariate models demonstrated a marked improvement in the discriminative power of the TIMI UA/NSTEMI model with the incorporation of heart failure and hemodynamic variables. ![]() There were 137 in-hospital deaths (4%), and among the survivors, 234 (7.4%) died by 6 months post-discharge. The predictive abilities of the TIMI and GRACE scores for in-hospital and 6-month mortality were assessed by calibration and discrimination. A simplified TIMI risk score was computed and was found to have similar prognostic ability as the 7 variable TIMI risk score.Ī modified TIMI risk score may simplify risk stratification of ED patients with undifferentiated chest pain.ACS patients admitted to the University of Michigan between 19 were divided into UA/NSTEMI (n = 2753) and STEMI (n = 698) subpopulations. 1.7 +/- 1.2, P or = 65 years, ST segment deviation > or = 0.5 mm elevated troponin I, and coronary stenosis > or = 50%) were independently associated with adverse events. The mean TIMI risk score was significantly higher in patients with an adverse event compared with those without (2.6 +/- 1.3 vs. At 30 days there were 48 (5%) deaths, 84 (9%) myocardial infarctions, and 49 (5%) coronary revascularization procedures. There were 151 (16%) patients diagnosed with ACS. A multivariate analysis was done to evaluate the independent predictive power of the individual components of the TIMI risk score to predict an adverse event at 30 days (all-cause death, myocardial infarction, and coronary revascularization). We investigated the prognostic utility of the TIMI risk score in 947 consecutive patients evaluated in the ED for possible ACS. The ability of the TIMI risk score to risk stratify patients at initial presentation in the ED with chest pain of unclear etiology is uncertain. To assess the prognostic utility of the Thrombolysis in Myocardial Infarction (TIMI) risk score in patients in the emergency department (ED) evaluated for possible acute coronary syndrome (ACS). ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |