Association of TIMI Risk Score with Angiographic Severity of Coronary Artery Disease in Patients with Non-ST Elevation Acute Coronary Syndrome

A. Bashiruddin, M. Chowdhury, Biplob Bhattachajee, S. Dhar, I. Mahmud, Md. Sahadat Hossain, A. Rahim
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Abstract

Background: Clinical guidelines recommend that optimal management of Non ST Elevation Acute Coronary Syndrome (NSTE-ACS) should include patient risk stratification. Predicting the anatomical extension of Coronary Artery Disease (CAD) is also potentially useful for clinical decision. 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 cross-sectional study was carried out in the Department of Cardiology, Chittagong Medical College Hospital (CMCH) on a total of 200 patients diagnosed with NSTE - ACS. TIMI risk score was calculated for each patient and they 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 Gensini score. Results: Mean (± SD) age was 53.7 (±10.8) years and 142 (71%) were male. Regarding cardiovascular risk factors, 68.5% had diabetes mellitus, 41.5% had dyslipidaemia, 77.5% had hypertension, 68% were current smoker and 35% had a family history of CAD. The Gensini score was higher in patients at high risk TIMI group. Moreover, there was a signi cant positive correlation between the TIMI and Gensini score (r=0.446). TIMI score can predict significant CAD moderately well (Area under the curve 0.661). Significantly higher proportion of patients with TIMI score more than 4 (65.9%) had significant three vessels CAD compared to patients with TIMI risk score 3-4 (17.9%) and TIMI risk score less than 3 (2%). Conclusion: TIMI score had good predictive value in assessment the severity of CAD in patients with NSTE-ACS JCMCTA 2021 ; 32 (1) : 26-30
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非st段抬高急性冠状动脉综合征患者TIMI风险评分与冠状动脉疾病血管造影严重程度的关系
背景:临床指南建议非ST段抬高急性冠脉综合征(NSTE-ACS)的最佳治疗应包括患者风险分层。预测冠状动脉疾病(CAD)的解剖扩展也可能对临床决策有用。我们研究的目的是确定TIMI风险评分是否与NSTE- ACS患者冠心病的血管造影程度和严重程度相关。材料与方法:本横断面研究在吉大港医学院附属医院心内科进行,共200例确诊为NSTE - ACS的患者。计算每位患者的TIMI风险评分,并根据TIMI风险评分将患者分为低危(0-2分)、中危(3-4分)、高危(5-7分)3组。采用Gensini评分评估冠心病的严重程度。结果:平均(±SD)年龄为53.7(±10.8)岁,男性142例(71%)。在心血管危险因素方面,68.5%的人患有糖尿病,41.5%的人患有血脂异常,77.5%的人患有高血压,68%的人目前吸烟,35%的人有冠心病家族史。高危TIMI组Gensini评分较高。TIMI与Gensini评分呈显著正相关(r=0.446)。TIMI评分能较好地预测显著性CAD(曲线下面积0.661)。TIMI评分大于4分的患者有明显三支血管CAD的比例(65.9%)明显高于TIMI风险评分为3-4分的患者(17.9%)和TIMI风险评分小于3分的患者(2%)。结论:TIMI评分对评估NSTE-ACSJCMCTA 2021患者CAD严重程度有较好的预测价值;32 (1): 26-30
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