The value of novel invasive hemodynamic parameters added to the TIMI risk score for short-term prognosis assessment in patients with ST segment elevation myocardial infarction

Abstract Background The model for end-stage liver disease excluding international normalized ratio (MELD-XI) is a simple score for risk assessment. However, the prognostic role of MELD-XI and its additional value to current risk assessment in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) is uncertain. Methods In all, 1029 elderly patients with STEMI undergoing PCI were consecutively included and classified into three groups according to the TIMI risk score: low-risk (≤ 3, n = 251); moderate-risk (4–6, n = 509); and high-risk (≥ 7, n = 269) groups. Multivariate analysis was performed to identify risk factors for adverse events. Results The overall in-hospital mortality was 5.3% and was significantly higher in the high-risk group (1.2% vs. 3.3% vs. 13.0%, p < 0.001). The optimal cut-off of the TIMI risk score and MELD-XI for in-hospital death was 7 and 13, respectively. MELD-XI was associated with in-hospital (adjusted odds ratio = 1.09, 95% CI = 1.04–1.14, p = 0.001) and one-year (adjusted hazard ratio = 1.05, 95% CI = 1.01–1.08, p = 0.005) mortality independently of the TIMI risk score. Combining TIMI risk score and MELD-XI exhibited better predictive power for in-hospital death than TIMI risk score (area under the curve [AUC] = 0.810 vs. 0.753, p = 0.008) or MELD-XI alone (AUC = 0.810 vs. 0.750, p = 0.018). Patients with TIMI risk score ≥ 7 and MELD-XI ≥ 13 had the worst prognosis. Conclusion MELD-XI could be considered as a risk-stratified tool for elderly patients with STEMI undergoing PCI. It had an additive prognostic value to TIMI risk score.

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An Asian Validation of the TIMI Risk Score for ST-Segment Elevation Myocardial Infarction

PLoS ONE ◽

10.1371/journal.pone.0040249 ◽

2012 ◽

Vol 7 (7) ◽

pp. e40249 ◽

Cited By ~ 9

Author(s):

Sharmini Selvarajah ◽

Alan Yean Yip Fong ◽

Gunavathy Selvaraj ◽

Jamaiyah Haniff ◽

Cuno S. P. M. Uiterwaal ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Score ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Timi Risk Score

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Comparison of SYNTAX score II efficacy with SYNTAX score and TIMI risk score for predicting in-hospital and long-term mortality in patients with ST segment elevation myocardial infarction

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-018-1333-1 ◽

2018 ◽

Vol 34 (8) ◽

pp. 1165-1175 ◽

Cited By ~ 4

Author(s):

Yavuz Karabağ ◽

Metin Çağdaş ◽

Ibrahim Rencuzogullari ◽

Süleyman Karakoyun ◽

İnanç Artaç ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Score ◽

Syntax Score ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Syntax Score Ii ◽

Timi Risk Score ◽

Long Term Mortality

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Value of TIMI Risk Score Combined With Global Longitudinal Strain for Predicting Major Adverse Cardiac Events After PCI in Patients With ST-Segment Elevation Myocardial Infarction

10.21203/rs.3.rs-838522/v1 ◽

2021 ◽

Author(s):

De Bin Yang ◽

Ying Chun Wang ◽

Wen Ye Zhu ◽

Jing Wang ◽

Lou Jin Rong ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Risk Score ◽

Coronary Intervention ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Percutaneous Coronary ◽

Timi Risk Score

Abstract PurposeAccurately assessing the predicting prognosis is important in ST-segment elevation myocardial infarction (STEMI). This study aimed to investigate the predictive value of the TIMI risk score combined with GLS for the occurrence of major adverse cardiovascular events (MACEs)in STEMI patients after percutaneous coronary intervention (PCI)MethodsAcute STEMI diagnosed between January 2019 to June 2021 were prospectively enrolled. GLS were performed to assess left ventricular dysfunction three days post-percutaneous coronary intervention (PCI). In a 12-month follow up, three prognostic models for MACE were established based on TIMI risk score alone, TIMI risk score + GLS, and TIMI risk score + GLS + clinical risk factors, respectively, and assessed for efficiency.ResultsA total of 138 patients were enrolled. According to the follow-up results, the incidence of MACE in the patients was 19.6% (27/138). Areas under the receiver operating characteristic (ROC) curves were 0.703, 0.810 and 0.815, respectively, in TIMI risk score alone, TIMI risk score + GLS, TIMI risk score + GLS + clinical risk factors, indicating a significantly higher value and more efficient assessment for TIMI risk score + GLS.ConclusionCompared with the TIMI risk score alone, TIMI risk score combined with GLS provides a more efficient assessment of risk for determining the prognosis of STEMI patients.

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Addition of routine blood biomarkers to TIMI risk score improves predictive performance of 1-year mortality in patients with ST-segment elevation myocardial infarction

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01777-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Pyung Chun Oh ◽

Young Sil Eom ◽

Jeonggeun Moon ◽

Ho-Jun Jang ◽

Tae-Hoon Kim ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Score ◽

Discriminative Ability ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

Routine Blood ◽

Net Reclassification Improvement ◽

C Statistic ◽

St Segment ◽

Timi Risk Score

Abstract Background Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase > twice the normal upper limit and glucose < 90 or > 250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR 2.019; 95% CI 1.104–3.695), dysglycemia (HR 2.535; 95% CI 1.324–3.923), anemia (HR 2.071; 95% CI 1.093–3.923), and high NLR (HR 3.651; 95% CI 1.927–6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p < 0.001), and the NRI and IDI were estimated at 0.203 (95% CI 0.130–0.275; p < 0.001) and 0.089 (95% CI 0.060–0.119; p < 0.001), respectively. Conclusions The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.

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Addition of routine blood biomarkers to TIMI risk score improves predictive performance of 1-year mortality in patients with ST-segment elevation myocardial infarction

10.21203/rs.3.rs-41698/v3 ◽

2020 ◽

Author(s):

Pyung Chun Oh ◽

Young Sil Eom ◽

Jeonggeun Moon ◽

Ho-Jun Jang ◽

Tae-Hoon Kim ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Score ◽

Discriminative Ability ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

Routine Blood ◽

Net Reclassification Improvement ◽

C Statistic ◽

St Segment ◽

Timi Risk Score

Abstract Background: Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods: A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase >twice the normal upper limit and glucose <90 or >250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR, 2.019; 95% CI, 1.104-3.695), dysglycemia (HR, 2.535; 95% CI, 1.324-3.923), anemia (HR, 2.071; 95% CI, 1.093-3.923), and high NLR (HR, 3.651; 95% CI, 1.927-6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p<0.001), and the NRI and IDI were estimated at 0.203 (95% CI, 0.130-0.275; p<0.001) and 0.089 (95% CI, 0.060-0.119; p<0.001), respectively. Conclusions: The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.

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Addition of Routine Blood Biomarkers to TIMI Risk Score Improves Predictive Performance of 1-year Mortality in Patients with ST-segment Elevation Myocardial Infarction

10.21203/rs.3.rs-41698/v1 ◽

2020 ◽

Author(s):

Pyung Chun Oh ◽

Young Sil Eom ◽

Jeonggeun Moon ◽

Ho-Jun Jang ◽

Tae-Hoon Kim ◽

...

Keyword(s):

Myocardial Infarction ◽

Risk Score ◽

Discriminative Ability ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

Routine Blood ◽

Net Reclassification Improvement ◽

C Statistic ◽

St Segment ◽

Timi Risk Score

Abstract Background: Several biomarkers have been proposed as independent predictors of poor outcomes in ST-segment elevation myocardial infarction (STEMI). We investigated whether adding information obtained from routine blood tests including hypoxic liver injury (HLI), dysglycemia, anemia, and high neutrophil to lymphocyte ratio (NLR) could improve the prognostic performance of the TIMI risk score for the prediction of 1-year mortality. Methods: A total of 1057 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) between 2007 and 2014 were retrospectively enrolled from 4-regional hospitals. HLI and dysglycemia were defined as serum transaminase >twice the normal upper limit and glucose <90 or >250 mg/dL, respectively. The effect of adding biomarkers to the TIMI risk score on its discriminative ability was assessed using c-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: The 1-year mortality rate was 7.1%. The best cutoff value of NLR for the prediction of 1-year mortality was 4.3 (sensitivity, 67%; specificity, 65%). HLI (HR, 2.019; 95% CI, 1.104-3.695), dysglycemia (HR, 2.535; 95% CI, 1.324-3.923), anemia (HR, 2.071; 95% CI, 1.093-3.923), and high NLR (HR, 3.651; 95% CI, 1.927-6.918) were independent predictors of 1-year mortality. When these 4 parameters were added to the TIMI risk score, the c-statistic significantly improved from 0.841 to 0.876 (p<0.001), and the NRI and IDI were estimated at 0.203 (95% CI, 0.130-0.275; p<0.001) and 0.089 (95% CI, 0.060-0.119; p<0.001), respectively. Conclusions: The addition of HLI, dysglycemia, anemia, and high NLR to the TIMI risk score may be useful for very early risk stratification in patients with STEMI receiving primary PCI.

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