Complementary prognostic values of ST segment deviation and Thrombolysis In Myocardial Infarction (TIMI) risk score in non-ST elevation acute coronary syndromes: Insights from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) study

Huynh, Thao; Nasmith, James; Bernier, Martin; Pharand, Chantal; Zhao, Xiaohui; Giugliano, Robert P.; Théroux, Pierre

doi:10.1016/s0828-282x(09)70536-7

Cited by 12 publications

(3 citation statements)

References 26 publications

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“… % No. % GRACE risk score [ 19 ] Low (1–108) 64 57.3 232 59.8 χ 2 = 2.67 MC p =0.28 Intermediate (109–140) 40 35.7 114 31.9 High (141–372) 8 7 32 8.3 TIMI risk score [ 20 ] Low (0–2) 20 17.8 80 20.6 χ 2 = 1.567 MC p =0.37 Intermediate (3–5) 82 73.3 268 69.1 High (>5) 10 8.9 40 10.3 χ 2 value for Chi square, MC Monte Carlo test *Statistically significant at p ≤ 0.05 …”

Section: Resultsmentioning

confidence: 99%

Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome

et al. 2021

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Background Significance of totally occluded culprit coronary artery in patients presenting with non-ST segment elevation myocardial infarction (NSTEMI) is underestimated. The aim of the study was to evaluate the incidence and impact of totally occluded culprit artery on in-hospital and 6 months follow-up outcomes of NSTEMI acute coronary syndrome (ACS) patients. Results We collected retrospectively data of 500 NSTEMI patients who presented to our hospital from June 2016 to June 2017. All patients underwent PCI within 72 h of presentation. We excluded patients with cardiogenic shock, prior CABG, and STEMI. Patients were divided into two groups according to pre-procedural culprit vessel thrombolysis in myocardial infarction (TIMI) flow. Group 1, TIMI flow 0 total coronary occlusion, included 112 patients (22.4%). Group 2, TIMI flow 1–3 non-total occlusion, included 388 patients (77.6%). Group 1 patients had significantly higher incidence of smoking (p=0.01), significantly higher level of cardiac enzymes (p<0.001), significantly more collaterals (p<0.001), and significantly more LCX and RCA as the culprit vessel (p<0.01), while group 2 patients had significantly higher incidence of diabetes (p=0.02) and significantly more LAD as the culprit vessel. There were no significant differences between the two groups regarding the major adverse cardiac and cerebrovascular events (MACCE) in-hospital (5.3% in totally occluded group vs. 1% in non-totally occluded group, p=0.07), but group 1 patients had significantly higher incidence of in-hospital arrhythmia (8.9% in group 1 vs. 1% in group 2, p=0.007). After 6 months follow-up, there were no significant differences regarding MACCE between the 2 groups after 6 months follow-up (5.4% in group 1 vs. 4.6% of group 2, P=0.24). Conclusion 22.4% of NSTEMI patients have a totally occluded culprit artery. The presence of an occluded culprit artery did not significantly affect the clinical outcomes of NSTEMI patients either in-hospital or after 6 months follow-up but was associated with significantly higher incidence of in-hospital arrhythmia.

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Section: Resultsmentioning

confidence: 99%

Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome

et al. 2021

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“…The necessity of identifying individual cardiac event/death risk of ACS patients is accepted worldwide and consequently many risk scoring systems have been developed by investigators (10,11). The most wellknown of these; Thrombosis In Myocardial Infarction (TIMI), Platelet glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) and Fast Revascularisation in Instability in Coronary (FRISC) disease scoring systems; separate patients into low-medium-high risk groups according to qualitative assessment (12)(13)(14). However, a scoring system that may predict the quantitative clinical risk exactly has not yet been de- (11,14).…”

Section: Discussionmentioning

confidence: 99%

Can GRACE Risk Score Predict the Coronary Anatomy in Non-ST Elevation Acute Coronary Syndrome?

Çağlar¹,

Başkurt²

2013

Istanbul Med J

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The Global Registry of Acute Coronary Events (GRACE) risk score; a commonly used risk scoring system; predicts hospital and 6-month survival rates of patients with acute coronary syndrome (ACS). The purpose of this study was to evaluate whether the GRACE risk score could also predict the extent of diseased coronary vessels in patients with non-ST elevation acute coronary syndrome. Methods: We evaluated 95 patient data retrospectively who were hospitalized with a diagnosis of non-ST elevation ACS between 2005-2006 at the Istanbul University Cardiology Institute. All the patients' GRACE risk scores were calculated and coronary angiograms were re-analysed. We further divided the patients into three groups according to risk score (Low risk score: <108, medium risk score: 109-140, high risk score: >141) and evaluated the association between the GRACE risk score and the number of diseased coronary arteries. Results: After GRACE risk score calculation; the number of low risk, medium risk and high risk patients were 38 (%40), 44 (%46.4) and 13 (%13.6) respectively. Three-vessel disease was insignificantly higher in low and medium risk groups but statistically significant in high risk group. (p<0.01). Patients with low ejection fraction (<40%) were more numerous in the high risk group than medium and low risk groups (p<0.05). number of patients with estimated glomerular filtration rate (eGFR) less than 60 mL/ dk/1.73 m 2 was higher in medium and high risk groups than the low risk group (p<0.001). Conclusion: As the GRACE risk score calculated in emergency room for ACS patients can predict in-hospital mortality and clinical events, it may also predict coronary anatomy, low ejection fraction and low eGFR.

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“…Demographic characteristics, medical history, ECG features, and leading symptoms were retrospectively entered into a database. Moreover, thrombolysis in myocardial infarction (TIMI) risk scores were calculated for all patients at admission [10]. The bleeding complication was classified according to noncoronary artery bypass graft TIMI bleeding criteria.…”

Section: Study Populationmentioning

confidence: 99%

Clinical implication of totally occluded infarct-related coronary artery in non-ST-segment elevation myocardial infarction: the TOTAL-NSTEMI study

Güner

Çörekçioğlu

Uzun

et al. 2022

Coronary Artery Disease

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Background A subset ofpatients found to have total occlusion of the culprit artery (TOCA), present with non-ST-segment elevation myocardial infarction (NSTEMI) and elevated biomarkers. The aim of this study is to assess the effect of the TOCA in patients presenting with NSTEMI. Methods This multicenter observational study was retrospectively conducted between 2015 and 2019. Thrombolysis in myocardial infarction (TIMI) flow grades 0–1 was defined as the TOCA. The primary end point included a combination of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis, and stroke. Results Of 3272 patients, TIMI 0–1 flow in the culprit artery was present in 488 (14.9%) patients. TOCA was more likely to be of thrombotic origin (54.1% vs. 10.3%; P < 0.001) and visible collaterals (22.5% vs. 4.4%; P < 0.001). The rates of 30-day (14.3% vs. 7.2%; P < 0.001) and 2-year (25% vs. 19.1%; P = 0.003) primary end points were significantly higher in TOCA patients. Fatal arrhythmias were remarkably higher at 30-day (8.6% vs. 4%; P < 0.001) and 2-year (9% vs. 5.2%; P = 0.001) follow-ups. Mechanical complications were also higher in patients with TOCA at 30 days (0.8% vs. 0.2%; P = 0.013). Moreover, TOCA (OR, 1.379; P = 0.001) was one of the independent predictors of MACCE in NSTEMI patients. Conclusion The current data suggest that patients with TOCA in the context of NSTEMI are at higher risk of MACCE, fatal arrhythmias, and mechanical complications.

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Cited by 12 publications

References 26 publications

Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome

Incidence and impact of totally occluded culprit coronary artery in patients with non-ST segment elevation myocardial infarction acute coronary syndrome

Can GRACE Risk Score Predict the Coronary Anatomy in Non-ST Elevation Acute Coronary Syndrome?

Clinical implication of totally occluded infarct-related coronary artery in non-ST-segment elevation myocardial infarction: the TOTAL-NSTEMI study

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