The TIMI risk score for unstable angina/non-ST elevation MI - A method for prognostication and therapeutic decision making

Simple item page
dc.contributor.authorAntman, EM
dc.contributor.authorCohen, M
dc.contributor.authorBernink, PJLM
dc.contributor.authorMcCabe, CH
dc.contributor.authorHoracek, T
dc.contributor.authorPapuchis, G
dc.contributor.authorMautner, B
dc.contributor.authorCorbalan, R
dc.contributor.authorRadley, D
dc.contributor.authorBraunwald, E
dc.date.accessioned2024-01-10T12:44:18Z
dc.date.available2024-01-10T12:44:18Z
dc.date.issued2000
dc.description.abstractContext Patients with unstable angina/non-ST-segment elevation myocardial infarction (MI) (UA/NSTEMI) present with a wide spectrum of risk for death and cardiac ischemic events.
dc.description.abstractObjective To develop a simple risk score that has broad applicability, is easily calculated at patient presentation, does not require a computer, and identifies patients with different responses to treatments for UA/NSTEMI.
dc.description.abstractDesign, Setting, and Patients Two phase 3, international, randomized, double-blind trials (the Thrombolysis in Myocardial Infarction [TIMI] 11B trial [August 1996-March 1998] and the Efficacy and Safety of Subcutaneous Enoxaparin in Unstable Angina and Non-Q-Wave MI trial [ESSENCE; October 1994-May 1996]). A total of 1957 patients with UA/NSTEMI were assigned to receive unfractionated heparin (test cohort) and 1953 to receive enoxaparin in TIMI 11B; 1564 and 1607 were assigned respectively in ESSENCE. The 3 validation cohorts were the unfractionated heparin group from ESSENCE and both enoxaparin groups.
dc.description.abstractMain Outcome Measures The TIMI risk score was derived in the test cohort by selection of independent prognostic variables using multivariate logistic regression, assignment of Value of 1 when a factor was present and 0 when it was absent, and summing the number of factors present to categorize patients into risk strata. Relative differences in response to therapeutic interventions were determined by comparing the slopes of the rates of events with increasing score in treatment groups and by testing for an interaction between risk score and treatment. Outcomes were TIMI risk score for developing at least 1 component of the primary end point (all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization) through 14 days after randomization.
dc.description.abstractResults The 7 TIMI risk score predictor variables were age 65 years or older, at least 3 risk factors for coronary artery disease, prior coronary stenosis of 50% or more, ST-segment deviation on electrocardiogram at presentation, at least 2 anginal events in prior 24 hours, use of aspirin in prior 7 days, and elevated serum card iac markers. Event rates increased significantly as the TIMI risk score increased in the test cohort in TIMI 11B: 4.7% for a score of 0/1; 8.3% for 2; 13.2% for 3; 19.9% for 4; 26.2% for 5; and 40.9% for 6/7 (P<.001 by chi(2) for trend). The pattern of increasing event rates with increasing TIMI risk score was confirmed in all 3 validation groups (P<.001). The slope of the increase in event rates with increasing numbers of risk factors was significantly lower in the enoxaparin groups in both TIMI 11B (P=.01) and ESSENCE (P=.03) and there was a significant interaction between TIMI risk score and treatment (P=.02).
dc.description.abstractConclusions In patients with UA/NSTEMI, the TIMI risk score is a simple prognostication scheme that categorizes a patient's risk of death and ischemic events and provides a basis for therapeutic decision making.
dc.fechaingreso.objetodigital02-04-2024
dc.format.extent8 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1001/jama.284.7.835
dc.identifier.issn0098-7484
dc.identifier.pubmedidMEDLINE:10938172
dc.identifier.urihttps://doi.org/10.1001/jama.284.7.835
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/77662
dc.identifier.wosidWOS:000088654400025
dc.information.autorucMedicina;Corbalán R;S/I;98700
dc.issue.numero7
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final842
dc.pagina.inicio835
dc.publisherAMER MEDICAL ASSOC
dc.revistaJAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
dc.rightsacceso restringido
dc.subjectWAVE MYOCARDIAL-INFARCTION
dc.subjectACUTE CORONARY SYNDROMES
dc.subjectCARDIAC TROPONIN-T
dc.subjectACUTE CHEST PAIN
dc.subjectEMERGENCY ROOM
dc.subjectARTERY DISEASE
dc.subjectSTRATIFICATION
dc.subjectISCHEMIA
dc.subjectTRIAL
dc.subjectELECTROCARDIOGRAM
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleThe TIMI risk score for unstable angina/non-ST elevation MI - A method for prognostication and therapeutic decision making
dc.typeartículo
dc.volumen284
sipa.codpersvinculados98700
sipa.indexWOS
sipa.indexPubmed
sipa.trazabilidadCarga SIPA;09-01-2024
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
The TIMI risk score for unstable angina-non-ST elevation MI-A method for prognostication and therapeutic decision making.pdf
Size:
3.82 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Artículos de revistas