scholarly journals Prediction of Major Adverse Cardiac Events of Patients with Acute Coronary Syndrome by Using TIMI Risk Score

2013 ◽  
Vol 8 (2) ◽  
pp. 73-79
Author(s):  
Mohammad Abul Ehsan ◽  
Manzoor Mahmood ◽  
Md Abu Siddique ◽  
Sajal Krishna Kanerjee ◽  
Laila Farzana Khan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Score ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Timi Score ◽  
Adverse Cardiac Events ◽  
St Elevation ◽  
Timi Risk Score

Background: Patient with acute coronary syndrome (ACS) has considerable variability in outcome and mortality risk. The Thrombolysis in Myocardial Infarction (TIMI) risk score for unstable angina/non ST elevation myocardial infarction & ST elevation myocardial infarction were a convenient bedside clinical risk score for predicting 30 days mortality at presentation with ACS. Aim & objectives: This study was done to predict and validate major adverse cardiac events in patients of ACS thus it will help us to quantify risk, observe the prognostic value and to guide appropriate therapy by using TIMI risk score. Methods: This prospective study was carried out in the department of cardiology, BSMMU, Dhaka from April, 2011 to March, 2012. After considering all ethical issues, data were collected from 279 patients attending at cardiac emergency department with the presentation of ACS. History & complete physical examinations were done. ST changes in electrocardiogram & CKMB/Troponin value were noted in data sheet. TIMI risk score was calculated for each patient. The major adverse cardiac events (recurrent myocardial infarction, urgent revascularization, and all-cause mortality) were measured for next 30 days in hospital setting & outpatient department by follow up. After follow-up, Cox univariate and multivariate regression analysis were used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the outcome. Results: In patient with UA/NSTEMI major adverse cardiac events were 0%, 4.2%, 6.9%, 12.5%, 13.6% and 33.3% with TIMI score 0/ 1, 2, 3, 4, 5 and 6/7 respectively. . In patients with STEMI group major adverse cardiac events were 0%, 0%, 0%, 0%, 7.1%, 9.5%, 10%, 17.6%, 19% and 38.5% with TIMI score 0, 1, 2, 3, 4, 5, 6, 7, 8 and more than 8 respectively. Conclusions: Increasing TIMI risk score was associated with increased risk of major adverse cardiac events. These score were a valid tool for risk assessment. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16063 University Heart Journal Vol. 8, No. 2, July 2012

scholarly journals Prediction of major adverse cardiac events of patients with acute coronary syndrome by using TIMI risk index

2013 ◽  
Vol 18 (2) ◽  
pp. 52-57 ◽  
Author(s):  
Mohammad Abul Ehsan ◽  
Md Manzoor Mahmood ◽  
Laila Farzana Khan ◽  
Md Abu Salim
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Risk Index ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events ◽  
St Elevation ◽  
Group 1

Patient with acute coronary syndrome (ACS) has considerable variability in outcome and mortality risk. The Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) for unstable angina/non ST elevation myocardial infarction & ST elevation myocardial infarction were a convenient bedside clinical risk score for predicting 30 days mortality at presentation with ACS. This study was done to predict and validate major adverse cardiac events in patients of ACS thus it will help us to quantify risk, observe the prognostic value and to guide appropriate therapy by using TRI. This prospective study was carried out in the department of cardiology, BSMMU, Dhaka from April, 2011 to March, 2012. After considering all ethical issues, data were collected from 279 patients attending at cardiac emergency department with the presentation of ACS. History & physical examinations were done. TIMI risk index were calculated for each patient. The major adverse cardiac events (recurrent myocardial infarction, urgent revascularization, and all-cause mortality) were measured for next 30 days in hospital setting & outpatient department by follow up. After follow-up, Cox univariate and multivariate regression analysis were used to evaluate the influence of potential risk factors on duration of event-free survival, and likelihood ratio tests to assess the outcome. Major adverse events of TIMI risk index group 1, 2, 3, 4 & 5 were 0%, 0%, 3.7%, 12.9% & 19.2% respectively in UA/NSTEMI group. In STEMI group major adverse cardiac events of TIMI risk index group 1, 2, 3, 4 & 5 were 0%, 4.7%, 12.5%, 17.1% & 24.1% respectively. Increasing TRI were associated with increased risk of major adverse cardiac events. These score were a valid tool for risk assessment. DOI: http://dx.doi.org/10.3329/jdnmch.v18i2.16024 J. Dhaka National Med. Coll. Hos. 2012; 18 (02): 52-57

scholarly journals Circulating Platelet-Derived Microparticles Associated with Postdischarge Major Adverse Cardiac Events in ST-Elevation Acute Myocardial Infarction

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Anggoro Budi Hartopo ◽  
Dyah Samti Mayasari ◽  
Ira Puspitawati ◽  
Hasanah Mumpuni
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Prognostic Implication ◽  
Adverse Cardiac Events ◽  
St Elevation ◽  
Elevation Acute Myocardial Infarction

Introduction. Platelet-derived microparticles (PDMPs) measurement adds prognostic implication for ST-elevation acute myocardial infarction (STEMI). The long-term implication of PDMPs in STEMI needs to be corroborated. Methods. The research design was a cohort study. Subjects were STEMI patients and were enrolled consecutively. The PDMPs were defined as microparticles bearing CD41(+) and CD62P(+) markers detected with flow cytometry. The PDMPs were measured on hospital admission and 30 days after discharge. The outcomes were major adverse cardiac events (MACE), i.e., a composite of cardiac death, heart failure, cardiogenic shock, reinfarction, and resuscitated ventricular arrhythmia, occurring from hospitalization until 1 year after discharge. Results. We enrolled 101 subjects with STEMI. During hospitalization, 17 subjects (16.8%) developed MACE. The PDMPs were not different between subjects with MACE and those without (median (IQR): 3305.0/μL (2370.0–14690.5/μL) vs. 4452.0/μL (2024.3–14396.8/μL), p=0.874). Forty-five subjects had increased PDMPs in 30 days after discharge as compared with on-admission measurement. Subjects with increased PDMPs had significantly higher 30-day MACE as compared to subjects with decreased PDMPs 17 (37.8%) vs. 6 (16.7%, p=0.036). There was a trend toward higher MACE in subjects with increased PDMPs as compared to those with decreased PDMPs in 90 days after discharge (48.9% vs. 30.6%, p=0.095) and 1 year after discharge (48.9% vs. 36.1%, p=0.249). Conclusion. The PDMPs level was increased from the day of admission to 30 days after discharge in patients with STEMI. The persistent increase in the PDMPs level in 30 days after the STEMI event was associated with the 30-day postdischarge MACE and trended toward increased MACE during the 90-day and 1-year follow-up.

scholarly journals Complications Associated to High TIMI Score in Patients with Acute ST Elevation Myocardial Infarction

2021 ◽  
Vol 15 (5) ◽  
pp. 1526-1528
Author(s):  
M. U. Rehman ◽  
F. Faisal ◽  
A. Abrar ◽  
A. A. Shah ◽  
M. Shoaib ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Stay ◽  
Risk Score ◽  
St Elevation Myocardial Infarction ◽  
Cross Sectional ◽  
Timi Score ◽  
Detailed Medical History ◽  
St Elevation ◽  
Timi Risk Score

Objective: To determine the complications associated to High TIMI risk score among patients presented with acute ST elevation myocardial infarction. Study Design: Cross sectional Place & Duration: Study was conducted at Cardiac Centre of Pakistan Institute of Medical Sciences (PIMS), Islamabadfor duration of 6 months from January to June, 2020. Methods: Total 290 patients of both genders with ages 35 to 80 years presented with acute myocardial infarction were included in this study. Patients detailed medical history including age, sex and residence were recorded. Thrombolysis in Myocardial Infarction (TIMI) risk score was calculated for each patient. Follow up was taken during the hospital stay and after discharge. Complications were recorded on follow-up. Data was analyzed by SPSS 21.0. Results: From all the patients high TIMI score was found in 34.48% patients. Out of 100 patients 70% were male and 30% were females with mean age 54.25+12.65 years. According to the high TIMI score 100 (34.48%) patients had score above 8 and 190 (65.52%) had score less than 8. Complications were recorded ad Ventricular fibrillation, VT, AF, Heart block, cardiogenic shock and pulmonary edema in 17%, 13%, 2%, 7%, 24% and 24% patients respectively.15% patients were died during hospital stay. 28% patients had post infarct angina, 9% patients had stroke and 28% patients treated revascularization. Conclusion: We concluded from this study that frequency of high TIMI score is high in our setting and we patients with increase score had high risk of complications and mortality. Keywords: High Thrombolysis in Myocardial Infarction, Acute ST Elevation Myocardial Infarction, Frequency, Complications, Mortality.

scholarly journals Pericoronary fat inflammation and Major Adverse Cardiac Events (MACE) in prediabetic patients with acute myocardial infarction: effects of metformin

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Celestino Sardu ◽  
Nunzia D’Onofrio ◽  
Michele Torella ◽  
Michele Portoghese ◽  
Francesco Loreni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adipose Tissue ◽  
Artery Bypass ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Metformin Therapy ◽  
Adverse Cardiac Events ◽  
Factor Α

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018

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