Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases?

Roy Soiza, S. J. Leslie, P. Williamson, S. Wai, Kirsten Ann Harrild, N. R. Peden, A. D. Hargreaves

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: Management of patients with an acute coronary syndrome (ACS) requires accurate risk stratification to guide appropriate therapy.

Aim: To assess the utility of the TIMI risk score in stratifying patients with possible ACS in routine clinical practice.

Design: Prospective observational study.

Methods: We recruited 869 consecutive patients with a diagnosis of possible ACS attending the acute medical receiving unit of a district general hospital. The main outcome measures were recurrent myocardial infarction, urgent revascularization, and all-cause mortality. TIMI risk score was calculated for each patient, and each was also assigned a risk group based on electrocardiogram (ECG) changes and troponin levels only. After follow-up, Cox univariate and multivariate regression was used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the fit of the models.

Results: Increasing TIMI risk score was associated with increased risk of events (p < 0.001), as was higher risk group from ECG plus troponin stratification (p < 0.001). The likelihood ratio comparison favoured the TIMI risk score (difference 13.910, 5 degrees of freedom, p = 0.016).

Discussion: The TIMI risk score is a valid tool for risk stratification in unselected cases with possible acute coronary syndrome. It is superior to ECG changes and troponin alone, although this simpler method also achieves good risk stratification.

Original languageEnglish
Pages (from-to)81-87
Number of pages6
JournalQJM
Volume99
Issue number2
DOIs
Publication statusPublished - Feb 2006

Keywords

  • WAVE MYOCARDIAL-INFARCTION
  • ST-SEGMENT ELEVATION
  • PLATELET GLYCOPROTEIN IIB/IIIA
  • CARDIAC TROPONIN-T
  • UNSTABLE ANGINA
  • CHEST-PAIN
  • CONSERVATIVE MANAGEMENT
  • GLOBAL REGISTRY
  • TIROFIBAN
  • INHIBITION

Cite this

Soiza, R., Leslie, S. J., Williamson, P., Wai, S., Harrild, K. A., Peden, N. R., & Hargreaves, A. D. (2006). Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases? QJM, 99(2), 81-87. https://doi.org/10.1093/qjmed/hcl001

Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases? / Soiza, Roy; Leslie, S. J.; Williamson, P.; Wai, S.; Harrild, Kirsten Ann; Peden, N. R.; Hargreaves, A. D.

In: QJM, Vol. 99, No. 2, 02.2006, p. 81-87.

Research output: Contribution to journalArticle

Soiza, R, Leslie, SJ, Williamson, P, Wai, S, Harrild, KA, Peden, NR & Hargreaves, AD 2006, 'Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases?', QJM, vol. 99, no. 2, pp. 81-87. https://doi.org/10.1093/qjmed/hcl001
Soiza, Roy ; Leslie, S. J. ; Williamson, P. ; Wai, S. ; Harrild, Kirsten Ann ; Peden, N. R. ; Hargreaves, A. D. / Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases?. In: QJM. 2006 ; Vol. 99, No. 2. pp. 81-87.
@article{d6e39cd332cd4b5081acf97b095be8c5,
title = "Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases?",
abstract = "Background: Management of patients with an acute coronary syndrome (ACS) requires accurate risk stratification to guide appropriate therapy.Aim: To assess the utility of the TIMI risk score in stratifying patients with possible ACS in routine clinical practice.Design: Prospective observational study.Methods: We recruited 869 consecutive patients with a diagnosis of possible ACS attending the acute medical receiving unit of a district general hospital. The main outcome measures were recurrent myocardial infarction, urgent revascularization, and all-cause mortality. TIMI risk score was calculated for each patient, and each was also assigned a risk group based on electrocardiogram (ECG) changes and troponin levels only. After follow-up, Cox univariate and multivariate regression was used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the fit of the models.Results: Increasing TIMI risk score was associated with increased risk of events (p < 0.001), as was higher risk group from ECG plus troponin stratification (p < 0.001). The likelihood ratio comparison favoured the TIMI risk score (difference 13.910, 5 degrees of freedom, p = 0.016).Discussion: The TIMI risk score is a valid tool for risk stratification in unselected cases with possible acute coronary syndrome. It is superior to ECG changes and troponin alone, although this simpler method also achieves good risk stratification.",
keywords = "WAVE MYOCARDIAL-INFARCTION, ST-SEGMENT ELEVATION, PLATELET GLYCOPROTEIN IIB/IIIA, CARDIAC TROPONIN-T, UNSTABLE ANGINA, CHEST-PAIN, CONSERVATIVE MANAGEMENT, GLOBAL REGISTRY, TIROFIBAN, INHIBITION",
author = "Roy Soiza and Leslie, {S. J.} and P. Williamson and S. Wai and Harrild, {Kirsten Ann} and Peden, {N. R.} and Hargreaves, {A. D.}",
year = "2006",
month = "2",
doi = "10.1093/qjmed/hcl001",
language = "English",
volume = "99",
pages = "81--87",
journal = "QJM",
issn = "1460-2725",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Risk stratification in acute coronary syndromes - does the TIMI risk score work in unselected cases?

AU - Soiza, Roy

AU - Leslie, S. J.

AU - Williamson, P.

AU - Wai, S.

AU - Harrild, Kirsten Ann

AU - Peden, N. R.

AU - Hargreaves, A. D.

PY - 2006/2

Y1 - 2006/2

N2 - Background: Management of patients with an acute coronary syndrome (ACS) requires accurate risk stratification to guide appropriate therapy.Aim: To assess the utility of the TIMI risk score in stratifying patients with possible ACS in routine clinical practice.Design: Prospective observational study.Methods: We recruited 869 consecutive patients with a diagnosis of possible ACS attending the acute medical receiving unit of a district general hospital. The main outcome measures were recurrent myocardial infarction, urgent revascularization, and all-cause mortality. TIMI risk score was calculated for each patient, and each was also assigned a risk group based on electrocardiogram (ECG) changes and troponin levels only. After follow-up, Cox univariate and multivariate regression was used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the fit of the models.Results: Increasing TIMI risk score was associated with increased risk of events (p < 0.001), as was higher risk group from ECG plus troponin stratification (p < 0.001). The likelihood ratio comparison favoured the TIMI risk score (difference 13.910, 5 degrees of freedom, p = 0.016).Discussion: The TIMI risk score is a valid tool for risk stratification in unselected cases with possible acute coronary syndrome. It is superior to ECG changes and troponin alone, although this simpler method also achieves good risk stratification.

AB - Background: Management of patients with an acute coronary syndrome (ACS) requires accurate risk stratification to guide appropriate therapy.Aim: To assess the utility of the TIMI risk score in stratifying patients with possible ACS in routine clinical practice.Design: Prospective observational study.Methods: We recruited 869 consecutive patients with a diagnosis of possible ACS attending the acute medical receiving unit of a district general hospital. The main outcome measures were recurrent myocardial infarction, urgent revascularization, and all-cause mortality. TIMI risk score was calculated for each patient, and each was also assigned a risk group based on electrocardiogram (ECG) changes and troponin levels only. After follow-up, Cox univariate and multivariate regression was used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the fit of the models.Results: Increasing TIMI risk score was associated with increased risk of events (p < 0.001), as was higher risk group from ECG plus troponin stratification (p < 0.001). The likelihood ratio comparison favoured the TIMI risk score (difference 13.910, 5 degrees of freedom, p = 0.016).Discussion: The TIMI risk score is a valid tool for risk stratification in unselected cases with possible acute coronary syndrome. It is superior to ECG changes and troponin alone, although this simpler method also achieves good risk stratification.

KW - WAVE MYOCARDIAL-INFARCTION

KW - ST-SEGMENT ELEVATION

KW - PLATELET GLYCOPROTEIN IIB/IIIA

KW - CARDIAC TROPONIN-T

KW - UNSTABLE ANGINA

KW - CHEST-PAIN

KW - CONSERVATIVE MANAGEMENT

KW - GLOBAL REGISTRY

KW - TIROFIBAN

KW - INHIBITION

U2 - 10.1093/qjmed/hcl001

DO - 10.1093/qjmed/hcl001

M3 - Article

VL - 99

SP - 81

EP - 87

JO - QJM

JF - QJM

SN - 1460-2725

IS - 2

ER -