1. Usefulness of the TIMI risk score in predicting both short- and long-term outcomes in the Veterans Affairs Non–Q-Wave Myocardial Infarction Strategies In-Hospital (VANQWISH) Trial
- Author
-
Samaha, Frederick F., Kimmel, Stephen E., Kizer, Jorge R., Goyal, Abhinav, Wade, Michael, and Boden, William E.
- Subjects
- *
THROMBOLYTIC therapy , *MYOCARDIAL infarction - Abstract
We sought to test the validity and clinical utility of the Thrombolysis In Myocardial Infarction (TIMI) risk score for patients who have non–Q-wave myocardial infarction. A post hoc analysis of the Veterans Affairs Non–Q-Wave Infarction Strategies In-Hospital (VANQWISH) Trial was performed, wherein patients were assigned a TIMI risk score from which both 30-day and 12-month outcomes (death, nonfatal myocardial infarction, or urgent revascularization) were assessed. At 30 days, the TIMI risk score showed a close match between observed and predicted probabilities of events after adjustment for overall event rates. The event rate at 30 days was 6% for a score of 0 to 2, 10% for a score of 3, 13% for a score of 4, and 14% for a score of 5 to 7 (p = 0.003 and c statistic 0.59). Discriminative ability of the score was greater in the conservative group at 30 days (p = 0.0004, c statistic 0.67). The score remained modestly predictive of events at 1 year (c statistic 0.60). Conservative strategy patients had better 30-day outcomes than the invasive strategy patients if their score was 0 to 2 (odds ratio 0.24, 95% confidence interval 0.08 to 0.76). No significant difference in outcomes between strategies was detected for a score ≥3. The TIMI risk score provides moderate incremental prognostic information in high-risk patients, during both short- and long-term follow-up. [Copyright &y& Elsevier]
- Published
- 2002
- Full Text
- View/download PDF