Objective: To evaluate the predicting values of thrombolysis in myocardial infarction (TIMI) risk scoring system for long-term prognosis in patients with ST segment elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention (PCI).
Methods: Eight clinical variables and their relative value of score derived from TIMI risk scoring system were used to determine individual's risk score. The patients with STEMI were evaluated during the period of in-hospital and followed-up at a mean of (23.9 +/- 3.8) months for major adverse cardiovascular events (MACE), including nonfatal heart failure, nonfatal re-infarction, target vessel revascularization and cardiac mortality and the predicting value of TIMI risk scores at hospital admission for total MACE were analyzed.
Results: Out of 373 patients with STEMI referred for primary PCI, 89 patients were presented with MACE during the period of follow-up (average incidence: 23.9%). The presentation of the total MACE increased progressively with the rising TIMI risk scores (P < 0.05 for trends in increase of MACE). The incidence of total MACE in patients with a score > or = 8 was 9 times those with a score 0. The incidence of cardiac mortality was higher (25% vs 0, P < 0.01) and the combined incidence of cardiac mortality and nonfatal re-infarction also increased significantly (36.7% vs 2.6%, P < 0.01) in patients with a score > or = 6 than in those with a score < 6 respectively. The risk of adverse cardiovascular events increased with rising in TIMI risk scores in patients with either high or normal TnI level.
Conclusions: The higher the TIMI risk score at admission, the worse the prognosis. This TIMI risk scoring system is likely to be a simple and practical tool at the bedside in quantitative risk evaluation and long-term prognosis prediction in patients with STEMI referred for primary PCI.