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The Relationship of the Extent of Coronary Artery Disease with TIMI Risk Model in Patients with Acute ST Segment Elevation Myocardial Infarction

Year 2014, Volume: 17 Issue: 1, 26 - 29, 01.01.2013
https://doi.org/10.4274/khj.7045

Abstract

OBJECTIVE: Preventive angioplasty may be useful for patients presenting with ST elevation myocardial infarction (STEMI), in whom multivessel disease was detected. TIMI risk scoring may be related to the severity of coronary artery disease (CAD) in these patients. This study aimed to investigate the relationship between the presence of multivessel disease on coronary angiograms and TIMI scores in patients with STEMI.METHODS: Ninety-one patients (73 males; 18 females) who presented with STEMI and treated with angioplasty were enrolled in the study. TIMI scores were calculated for all patients at presentation and the patients were classified into low (0-4) and high (5-14) risk groups based on TIMI scores. The extent of CAD was determined by experienced operators. One-way ANOVA was used for comparisons.RESULTS: Low TIMI risk score group included 70 (76.9%) patients and high TIMI risk score group included 21 (23.1%) patients. Coronary angiography results showed that 44 (48.4%) patients had involvement of 1 vessel, 24 (26.4%) patients had involvement of 2 vessels, and 23 (25.2%) patients had involvement of 3 vessels. There was no relationship between TIMI scores and the extent of CAD in patients (p=0.522).CONCLUSION: There was no association between TIMI scores and the extent of CAD in STEMI patients. TIMI risk scoring may not be useful in triage of STEMI patients. Future studies assessing the relationship between other risk scores and the extent of CAD would be still relevant and of great interest.

References

  • Thune JJ, Hoefsten DE, Lindholm MG, Mortensen LS, Andersen HR, Nielsen TT, et al. Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction (DANAMI)-2 Investigators. Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty. Circulation 2005;112:2017-21.
  • Luchi RJ, Scott SM, Deupree RH. Comparison of medical and surgical treatment for unstable angina pectoris. Results of a Veterans Administration Cooperative Study. N Engl J Med 1987;316:977-84.
  • Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, et al. TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation 2000;102:2031-7.
  • González-Pacheco H, Arias-Mendoza A, Alvarez-Sangabriel A, Juárez-Herrera U, Damas F, Eid-Lidt G, et al. The TIMI risk score for STEMI predicts in- hospital mortality and adverse events in patients without cardiogenic shock undergoing primary angioplasty. Arch Cardiol Mex 2012;82:7-13.
  • Wald DS, Morris JK, Wald NJ, Chase AJ, Edwards RJ, Hughes LO, et al. PRAMI Investigators. Randomized trial of preventive angioplasty in myocardial infarction. N Engl J Med 2013;369:1115-23.
  • Meier P, Lansky AJ, Baumbach A. Almanac 2013: acute coronary syndromes. Acta Cardiol 2014;69:100-8.
  • Filipiak KJ, Koltowski L, Grabowski M, Karpinski G, Glowczynska R, Huczek Z, et al. Prospective comparison of the 5 most popular risk scores in clinical use for unselected patients with acute coronary syndrome. Circ J 2011;75:167-73.
  • Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997;349:1498-504.
  • Garcia S, Canoniero M, Peter A, de Marchena E, Ferreira A. Correlation of TIMI risk score with angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndromes. Am J Cardiol 2004;93:813-6.
  • Busk M, Maeng M, Rasmussen K, Kelbaek H, Thayssen P, Abildgaard U, et al; DANAMI-2 Investigators. The Danish multicentre randomized study of fibrinolytic therapy vs. primary angioplasty in acute myocardial infarction (the DANAMI-2 trial): outcome after 3 years follow-up. Eur Heart J 2008;29:1259-66.
  • McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med 2011;124:40-7.
  • Golabchi A, Sadeghi M, Sanei H, Akhbari MR, Seiedhosseini SM, Khosravi P, et al. Can timi risk score predict angiographic involvement in patients with st-elevation myocardial infarction? ARYA Atheroscler 2010;6:69-73.

Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi

Year 2014, Volume: 17 Issue: 1, 26 - 29, 01.01.2013
https://doi.org/10.4274/khj.7045

Abstract

AMAÇ: Koruyucu anjiyoplasti, ST yükselmeli miyokard infarktüsü (STYME)'nde çoklu damar hastalığı saptanan hastalarda faydalı olabilir. TIMI risk skorlaması bu hastalarda koroner arter hastalığı (KAH)'nın yaygınlığı ile ilişkili olabilir. Bu çalışmada, STYME ile başvuran hastaların koroner anjiyografilerinde saptanan çoklu damar hastalığının TIMI skorları ile olan ilişkisinin araştırılması amaçlanmıştır.YÖNTEMLER: Çalışmaya, STYME ile başvuran ve anjiyoplasti ile tedavi edilen 91 (73 erkek; 18 kadın) hasta dahil edilmiştir. Tüm hastalar için başvuru sırasındaki TIMI skorları hesaplanmış, hastalar TIMI skorlamasına göre düşük (0-4) ve yüksek (5-14) risk gruplarına ayrılmıştır. KAH yaygınlığı deneyimli operatörler tarafından belirlenmiştir. Karşılaştırmalar tek yönlü ANOVA yöntemi kullanılarak yapılmıştır. BULGULAR: Düşük TIMI skorlu grupta 70 (%76,9), yüksek TIMI skorlu grupta 21 (%23,1) hasta vardı. Hastaların koroner anjiyografi sonuçlarına göre 44 (%48,4) hastada bir damar tutulumu, 24 (%26,4) hastada iki damar tutulumu, 23 (%25,2) hastada da üç damar tutulumu mevcuttu. Hastaların TIMI skorları ile KAH yaygınlığı arasında bir ilişki yoktu (p=0,522).SONUÇ: STYME hastalarında TIMI skorları ile KAH yaygınlığı arasında ilişki saptanmadı. STYME hastalarının triyajında TIMI risk skorlaması faydalı olmayabilir. Gelecekteki çalışmalarda diğer risk skorlarının KAH yaygınlığı ile olan ilişkisinin araştırılması halen güncel ve incelemeye değer olacaktır.

References

  • Thune JJ, Hoefsten DE, Lindholm MG, Mortensen LS, Andersen HR, Nielsen TT, et al. Danish Multicenter Randomized Study on Fibrinolytic Therapy Versus Acute Coronary Angioplasty in Acute Myocardial Infarction (DANAMI)-2 Investigators. Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty. Circulation 2005;112:2017-21.
  • Luchi RJ, Scott SM, Deupree RH. Comparison of medical and surgical treatment for unstable angina pectoris. Results of a Veterans Administration Cooperative Study. N Engl J Med 1987;316:977-84.
  • Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, et al. TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation 2000;102:2031-7.
  • González-Pacheco H, Arias-Mendoza A, Alvarez-Sangabriel A, Juárez-Herrera U, Damas F, Eid-Lidt G, et al. The TIMI risk score for STEMI predicts in- hospital mortality and adverse events in patients without cardiogenic shock undergoing primary angioplasty. Arch Cardiol Mex 2012;82:7-13.
  • Wald DS, Morris JK, Wald NJ, Chase AJ, Edwards RJ, Hughes LO, et al. PRAMI Investigators. Randomized trial of preventive angioplasty in myocardial infarction. N Engl J Med 2013;369:1115-23.
  • Meier P, Lansky AJ, Baumbach A. Almanac 2013: acute coronary syndromes. Acta Cardiol 2014;69:100-8.
  • Filipiak KJ, Koltowski L, Grabowski M, Karpinski G, Glowczynska R, Huczek Z, et al. Prospective comparison of the 5 most popular risk scores in clinical use for unselected patients with acute coronary syndrome. Circ J 2011;75:167-73.
  • Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. Lancet 1997;349:1498-504.
  • Garcia S, Canoniero M, Peter A, de Marchena E, Ferreira A. Correlation of TIMI risk score with angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndromes. Am J Cardiol 2004;93:813-6.
  • Busk M, Maeng M, Rasmussen K, Kelbaek H, Thayssen P, Abildgaard U, et al; DANAMI-2 Investigators. The Danish multicentre randomized study of fibrinolytic therapy vs. primary angioplasty in acute myocardial infarction (the DANAMI-2 trial): outcome after 3 years follow-up. Eur Heart J 2008;29:1259-66.
  • McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ. Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med 2011;124:40-7.
  • Golabchi A, Sadeghi M, Sanei H, Akhbari MR, Seiedhosseini SM, Khosravi P, et al. Can timi risk score predict angiographic involvement in patients with st-elevation myocardial infarction? ARYA Atheroscler 2010;6:69-73.
There are 12 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Yalın Tolga Yaylalı This is me

Mehmet Sercan Ertu&;rk This is me

Mustafa Yurtdaş This is me

Barış Önder Pamuk This is me

Publication Date January 1, 2013
Published in Issue Year 2014 Volume: 17 Issue: 1

Cite

APA Yaylalı, Y. T. ., Ertu&;rk, M. S. ., Yurtdaş, M. ., Pamuk, B. Ö. . (2013). Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi. Koşuyolu Kalp Dergisi, 17(1), 26-29. https://doi.org/10.4274/khj.7045
AMA Yaylalı YT, Ertu&;rk MS, Yurtdaş M, Pamuk BÖ. Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi. Koşuyolu Kalp Dergisi. January 2013;17(1):26-29. doi:10.4274/khj.7045
Chicago Yaylalı, Yalın Tolga, Mehmet Sercan Ertu&;rk, Mustafa Yurtdaş, and Barış Önder Pamuk. “Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli Ile İlişkisi”. Koşuyolu Kalp Dergisi 17, no. 1 (January 2013): 26-29. https://doi.org/10.4274/khj.7045.
EndNote Yaylalı YT, Ertu&;rk MS, Yurtdaş M, Pamuk BÖ (January 1, 2013) Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi. Koşuyolu Kalp Dergisi 17 1 26–29.
IEEE Y. T. . Yaylalı, M. S. . Ertu&;rk, M. . Yurtdaş, and B. Ö. . Pamuk, “Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi”, Koşuyolu Kalp Dergisi, vol. 17, no. 1, pp. 26–29, 2013, doi: 10.4274/khj.7045.
ISNAD Yaylalı, Yalın Tolga et al. “Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli Ile İlişkisi”. Koşuyolu Kalp Dergisi 17/1 (January 2013), 26-29. https://doi.org/10.4274/khj.7045.
JAMA Yaylalı YT, Ertu&;rk MS, Yurtdaş M, Pamuk BÖ. Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi. Koşuyolu Kalp Dergisi. 2013;17:26–29.
MLA Yaylalı, Yalın Tolga et al. “Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli Ile İlişkisi”. Koşuyolu Kalp Dergisi, vol. 17, no. 1, 2013, pp. 26-29, doi:10.4274/khj.7045.
Vancouver Yaylalı YT, Ertu&;rk MS, Yurtdaş M, Pamuk BÖ. Akut ST Yükselmeli Miyokart Enfarktüslü Hastalarda Koroner Arter Hastalığı Yaygınlığının TIMI Risk Modeli ile İlişkisi. Koşuyolu Kalp Dergisi. 2013;17(1):26-9.