scholarly journals Association of Thrombolysis in Myocardial Infarction (TIMI) Risk Score with Angiographic Severity of Coronary Artery Disease In Patients with Non-ST Elevation Acute Coronary Syndrome

2019 ◽  
Vol 15 (2) ◽  
pp. 68-73
Author(s):  
ABK Bashiruddin ◽  
Mohammad Ibrahim Chowdhury ◽  
Biplob Bhattacharjee ◽  
Abul Hossen Shahin ◽  
Syed Ali Ahsan ◽  
...  

Background: Clinical guidelines recommend that optimal management of acute coronary syndrome (ACS) should include patient risk stratification. Predicting the anatomical extension of coronary artery disease (CAD) is also potentially useful for clinical decision. Objective: The objective of our study was to determine whether the TIMI risk score correlates with the angiographic extent and severity of CAD in patients with NSTE- ACS. Materials and Methods: This was a cross-sectional observational study carried out in the Department of Cardiology, Chattogram Medical College Hospital (CMCH) from September 2017 to May 2018. A total of 200 patients diagnosed with NSTE- Acute Coronary Syndrome were included as sample by purposive sampling method. TIMI risk score for each patient was calculated and the patients were stratified into 3 groups according to the TIMI risk score: low risk (0-2); intermediate risk (3-4); high risk (5-7). The severity of the CAD was assessed by Vessel score and Gensini score. Result: The mean ± SD of the age of study population was 53.7 ±10.8 years (range 37–77) and 142 (71%) were male. Regarding cardiovascular risk factors, 137 (68.5%) patients had diabetes mellitus, 83 (41.5%) had dyslipidaemia, 155 (77.5%) had hypertension, 136 (68%) were current smoker and 70 (35%) had a family history of CAD. The Gensini score was higher in patients at high risk TIMI group (p<0.001). Moreover, there was a signiûcant positive correlation between the TIMI and Gensini score (r=0.446,p<0.001). TIMI score can predict significant CAD moderately well (area under the curve 0.661, p=0.001). Patients with TIMI score > 4 were more likely to have significant three vessel CAD (65.9%) versus those with TIMI risk score 3-4 (17.9%) and TIMI risk score < 3 (2%) (p< 0.001). Conclusion: Study showed the TIMI score is significantly correlated with the extent of CAD as assessed by the Gensini score. It is accurate for predicting severe CAD among NSTE-ACS patients. University Heart Journal Vol. 15, No. 2, Jul 2019; 68-73

2016 ◽  
Vol 15 (4) ◽  
pp. 138-144 ◽  
Author(s):  
Matthew T. Crim ◽  
Scott A. Berkowitz ◽  
Mustapha Saheed ◽  
Jason Miller ◽  
Amy Deutschendorf ◽  
...  

Author(s):  
Negar Omidi ◽  
Saeed Sadeghian ◽  
Mojtaba Salarifar ◽  
Arash Jalali ◽  
Seyed Hesameddin Abbasi ◽  
...  

Background: Acute coronary syndrome (ACS) is one of the main causes of mortality worldwide. We sought to evaluate the correlation between the severity of coronary artery disease (CAD) and conventional coronary artery risk factors in a large cohort of patients with ACS. Methods: This study included all patients admitted to the coronary care unit with a diagnosis of ACS between 2003 and 2017. The patients were divided into 2 groups: 1) unstable angina and 2) myocardial infarction. The aims of this study were to evaluate the effects of the risk factors and extension of coronary artery stenosis in patients with ACS according to the Gensini score. Results: Of a total 40 319 patients who presented with ACS, 18 862 patients (mean age =60.4±11.14 y, male: 67.2%) underwent conventional coronary angiography and met our criteria to enter the final analysis. The median of the Gensini score was 50 (25–88) in the study population. The multivariable analysis showed that age, sex, diabetes mellitus, hypertension, dyslipidemia, family history, cigarette smoking, opium consumption, and myocardial infarction increased the risk of positive Gensini scores. All the aforementioned risk factors, except cigarette smoking and opium consumption, increased the severity of stenosis in those with positive Gensini scores. The strongest relationship was seen vis-à-vis myocardial infarction, sex, and diabetes mellitus. Conclusion: Our findings suggest that age, sex, diabetes mellitus, dyslipidemia, hypertension, family history, and myocardial infarction have significant effects on the severity of CAD. The obesity paradox in relation to CAD should be taken into consideration and needs further investigation in patients with ACS.


2015 ◽  
Vol 22 (12) ◽  
pp. 1569-1573
Author(s):  
Muhammad Ijaz Bhatti ◽  
Usman Javed Iqbal ◽  
Nasir Iqbal

Background: Thrombolysis In Myocardial Infarction (TIMI) risk score predictsadverse clinical outcomes in patients with non–ST-elevation acute coronary syndromes(NSTEACS). Whether this score correlates with the coronary anatomy is unknown. Objective:To determine the frequency of low, moderate and high TIMI risk score in patients of NSTEACSand to compare the frequency of two vessel coronary artery disease on angiography withlow, moderate and high TIMI risk scores in patients of NSTE-ACS. Study design: This was across sectional study. Setting: Department of Cardiology, Gulab Devi Chest Hospital, Lahore.Duration: Six months. Patients and Methods: Total 170 patients were included in the study.Patients’ selection was done with the help of a pre-defined inclusion and exclusion criteria. TIMIrisk score was calculated for each patient and patients were categorized into low, moderate andhigh risk groups (as per operational definition). Patients were further evaluated with coronaryangiograms to assess the double vessel CAD. All angiographies were performed by a singlephysician. Data analysis was done on SPSS version 17. Results: Mean age of our patients was54.81±10.55 years. Gender distribution shows that there were 106(62%) male and 64(38%)female patients. TIMI score risk classification showed that among 50(29.4%) patients TIMI riskscore was low, among 107(62.9%) patients it was moderate and in 13(7.6%) patients it washigh. There were 105(62%) patients who had two vessel coronary artery disease. Among 105patients who had two vessel coronary artery disease, 25(23.8%) had low TIMI score, 69(65.7%)had moderate and 11(10.5%) of the patients had high TIMI score. Conclusion: In patientswith non-ST-elevation acute coronary syndrome undergoing cardiac catheterization, the TIMIrisk score is significantly associated with two vessel coronary artery disease. So it should berecommended that a routine invasive strategy be carried in patients with moderate or higherTIMI risk score.


2015 ◽  
Vol 4 (3) ◽  
pp. 216-221
Author(s):  
Adem Bekler ◽  
Gökhan Erbağ ◽  
Hacer Şen ◽  
Muhammed Turgut, Alper Özkan ◽  
Ali Ümit Yener ◽  
...  

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S787-91
Author(s):  
Saleha Abbas ◽  
Abdul Hameed Siddiqui ◽  
Ammar Cheema ◽  
Ayesha Abbas ◽  
Syed Khawar Abbas Jaffri ◽  
...  

Objective: To evaluate the correlation between thrombolytic in Myocardial Infarction risk score with the severity of coronary lesions found by coronary angiography during hospitalization in patients with non-ST elevation Acute coronary syndrome. Study Design: Cross sectional study. Place and Duration of Study: Adult Cardiology department, Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi from Jul to Dec 2018.Methodology: Patients who had chest pain suggestive of angina or anginal equivalent symptoms and diagnosis of Acute Coronary Syndrome (ACS) were included in the study. Patients with Acute Coronary Syndrome were risk stratified with Thrombolysis In Myocardial Infarction risk scores and were further evaluated with coronary angiograms to assess the extent of coronary artery disease. Results: Total 115 patients were recruited in the study with mean age 57.08 ± 10.2 years. There were 87 (75.7%) male patients while 28 (24.3%) female patients. The most common co-morbidity was hypertension 66 (57.4%) followed by diabetes mellitus 39 (33.9%) and smoking 25 (21.7%). 71 (61.7%) patients had one angina episode in the last 2 hours while 34 patients had two angina episodes in the last 2 hours. Cardiac biomarkers were raised in 36 (31.3%) patients. 60 (52.2%) used aspirin in the last 7 days. Chi-square test was applied between Thrombolysis In Myocardial Infarction Score and Coronaries lesions, which showed statistically significant results (p<0.001). Conclusion: Our study demonstrates that among patients presenting with Non-STE Acute coronary syndrome i.e. unstable angina /NSTEMI who are referred for coronary angiography, clinical risk stratification according......


Cells ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1143
Author(s):  
Jeremy Yuvaraj ◽  
Andrew Lin ◽  
Nitesh Nerlekar ◽  
Ravi K. Munnur ◽  
James D. Cameron ◽  
...  

Background: High-risk plaques (HRP) detected on coronary computed tomography angiography (CTA) confer an increased risk of acute coronary syndrome (ACS). Pericoronary adipose tissue attenuation (PCAT) is a novel biomarker of coronary inflammation. This study aimed to evaluate the association of PCAT with HRP and subsequent ACS development in patients with stable coronary artery disease (CAD). Methods: Patients with stable CAD who underwent coronary CTA from 2011 to 2016 and had available outcome data were included. We studied 41 patients with HRP propensity matched to 41 controls without HRP (60 ± 10 years, 67% males). PCAT was assessed using semi-automated software on a per-patient basis in the proximal right coronary artery (PCATRCA) and a per-lesion basis (PCATLesion) around HRP in cases and the highest-grade stenosis lesions in controls. Results: PCATRCA and PCATLesion were higher in HRP patients than controls (PCATRCA: −80.7 ± 6.50 HU vs. −84.2 ± 8.09 HU, p = 0.03; PCATLesion: −79.6 ± 7.86 HU vs. −84.2 ± 10.3 HU, p = 0.04), and were also higher in men (PCATRCA: −80.5 ± 7.03 HU vs. −86.1 ± 7.08 HU, p < 0.001; PCATLesion: −79.6 ± 9.06 HU vs. −85.2 ± 7.96 HU, p = 0.02). Median time to ACS was 1.9 years, within a median follow-up of 5.3 years. PCATRCA alone was higher in HRP patients who subsequently presented with ACS (−76.8 ± 5.69 HU vs. −82.0 ± 6.32 HU, p = 0.03). In time-dependent analysis, ACS was associated with HRP and PCATRCA. Conclusions: PCAT attenuation is increased in stable CAD patients with HRP and is associated with subsequent ACS development. Further investigation is required to determine the clinical implications of these findings.


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