Garcia Santiago, Canoniero Mariana, Peter Arley, de Marchena Eduardo, Ferreira Alexandre
Division of Cardiology, Department of Medicine, Jackson Memorial Hospital, University of Miami School of Medicine, Miami, Florida, USA.
Am J Cardiol. 2004 Apr 1;93(7):813-6. doi: 10.1016/j.amjcard.2003.12.015.
The Thrombolysis In Myocardial Infarction (TIMI) risk score predicts adverse clinical outcomes in patients with non-ST-elevation acute coronary syndromes (NSTEACS). Whether this score correlates with the coronary anatomy is unknown. We sought to determine whether the TIMI risk score correlates with the angiographic extent and severity of coronary artery disease (CAD) in patients with NSTEACS undergoing cardiac catheterization. We conducted a retrospective review of 688 consecutive medical records of patients who underwent coronary angiography secondary to NSTEACS. Patients were classified into 3 categories according to TIMI risk score: TIMI scores 0 to 2 (n = 284), 3 to 4 (n = 301), and 5 to 7 (n = 103). One-vessel disease was found in patients with TIMI score 3 to 4 as often as in patients with TIMI score 0 to 2 (odds ratio [OR] 1.08, 95% confidence interval [CI] 0.74 to 1.56; p = 0.66). However, 1-vessel disease was found more often in patients with TIMI score 3 to 4 than in patients with TIMI score 5 to 7 (OR 2.16, 95% CI 1.18 to 3.95; p = 0.01), and in patients with TIMI score 0 to 2 than in those with TIMI score 5 to 7 (OR 1.99, 95% CI 1.08 to 3.66; p = 0.02). Two-vessel disease was more likely found in patients with TIMI score 3 to 4 than in those with TIMI scores 0 to 2 (OR 3.96, 95% CI 2.41 to 6.53; p <0.001) and 5 to 7 (OR 2.05, 95% CI 1.12 to 3.75; p = 0.004). Three-vessel or left main disease was more likely found in patients with TIMI score 3 to 4 than in patients with TIMI score 0 to 2 (OR 3.19, 95% CI 2.00 to 5.10; p <0.001), and in patients with TIMI score 5 to 7 than in patients with TIMI score 3 to 4 (OR 6.34, 95% CI 3.88 to 10.36; p <0.001). In patients with NSTEACS undergoing cardiac catheterization, the TIMI risk score correlated with the extent and severity of CAD.
心肌梗死溶栓（TIMI）风险评分可预测非ST段抬高型急性冠状动脉综合征（NSTEACS）患者的不良临床结局。该评分是否与冠状动脉解剖结构相关尚不清楚。我们试图确定在接受心脏导管插入术的NSTEACS患者中，TIMI风险评分是否与冠状动脉疾病（CAD）的血管造影范围和严重程度相关。我们对688例因NSTEACS接受冠状动脉造影的患者的连续病历进行了回顾性分析。根据TIMI风险评分将患者分为3类：TIMI评分0至2分（n = 284）、3至4分（n = 301）和5至7分（n = 103）。TIMI评分3至4分的患者中发现单支血管病变的频率与TIMI评分0至2分的患者相同（优势比[OR] 1.08，95%置信区间[CI] 0.74至1.56；p = 0.66）。然而，TIMI评分3至4分的患者中发现单支血管病变的频率高于TIMI评分5至7分的患者（OR 2.16，95% CI 1.18至3.95；p = 0.01），且高于TIMI评分0至2分的患者（OR 1.99，95% CI 1.08至3.66；p = 0.02）。TIMI评分3至4分的患者中发现双支血管病变的可能性高于TIMI评分0至2分的患者（OR 3.96，95% CI 2.41至6.53；p <0.001）和TIMI评分5至7分的患者（OR 2.05，95% CI 1.12至3.75；p = 0.004）。TIMI评分3至4分的患者中发现三支血管或左主干病变的可能性高于TIMI评分0至2分的患者（OR 3.19，95% CI 2.00至5.10；p <0.001），且高于TIMI评分5至7分的患者（OR 6.34，95% CI 3.88至10.36；p <0.001）。在接受心脏导管插入术的NSTEACS患者中，TIMI风险评分与CAD的范围和严重程度相关。
