Garcia-Almagro et al developed a modified Thrombolysis in Myocardial Infarction (TIMI) Risk Score (TRSm) to evaluate a patient with chest pain. The authors are from University Hospital Virgen de la Arrixaca and General Section of Public Health in Marcia, Spain.
Patient selection: chest pain, without ST-segment elevation at initial presentation
Outcome: cardiovascular death, acute myocardial infarction, need for revascularization at 1 and 6 months
Parameters:
(1) age in years
(2) number of coronary artery disease (CAD) risk factors
(3) known coronary artery disease (CAD) based on stenosis in previous coronary angiogram >= 50%
(4) ASA (aspirin) consumption in past week
(5) ST segment deviation in presentation ECG >= 0.5 mm
(6) cardiac markers (troponin, less often CK-MB)
(7) diabetes
(8) left ventricular ejection fraction (LVEF) in percent
Coronary artery disease risk factors:
(2) hypercholesterolemia
(3) diabetes
(4) smoking
(5) family history of ischemic heart disease
|
Parameters |
Finding |
Points |
|
age in years |
< 65 years of age |
0 |
|
|
>= 65 years |
1 |
|
number of risk factors |
0 to 2 |
0 |
|
|
3 to 5 |
1 |
|
known CAD |
no |
0 |
|
|
yes |
1 |
|
ASA consumption |
no |
0 |
|
|
yes |
1 |
|
ST segment deviation |
no |
0 |
|
|
yes |
1 |
|
cardiac markers |
no |
0 |
|
|
yes |
1 |
|
diabetes |
no |
0 |
|
|
yes |
1 |
|
LVEF |
>= 45% |
0 |
|
|
35 to 44.9% |
1 |
|
|
< 35% |
2 |
total score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the worse the prognosis
Specialty: Cardiology
