Correlation of TIMI Risk Score and Major Adverse Cardiac Events in Patients with ST Segment Elevated Myocardial Infarction

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Introduction: Considerable variability in mortality risk exists among patients with ST-elevation myocardial infarction (STEMI), therefore the implementation of risk predictive models is required. The Thrombolysis in Myocardial Infarction (TIMI) risk score is derived from clinical trial involving patients who are eligible for fibrinolysis. TIMI risk score for ST elevation myocardial infarction (STEMI) is an important tool to assess mortality risk; however, it has not yet been well studied in our country. Objective: To see the correlation of TIMI risk score with major adverse cardiac events (MACE) in patients with STEMI. Methodology: This cross-sectional prospective study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet during the period from July 2017 to June 2018. Fifty patients with definite diagnosis of acute STEMI, received streptokinase, aged above 18 years and both sex were included. Prior myocardial infarction, coronary revascularization procedures either CABG or angioplasty or coronary stenting; co-morbidities such as renal failure, heart failure, cardiomyopathy, valvular heart disease and congenital heart disease were excluded. On admission TIMI was recorded. In hospital MACE were also recorded. Results: The mean age of patients was 52.64 (SD 11.88) years and majority of the patients were male (84%) with male to female ratio was 5.25:1. Smoking was the most prevalent risk factor (64.0%) followed by hypertension (34.0%), diabetes mellitus (26.0%), dyslipidemia (32.0%) and family history of ischaemic heart disease (28.0%). The mean TIMI risk score for STEMI 4.50 (SD 2.38). In hospital major adverse cardiac events (MACE) occurred in 19 (38.0%) cases. TIMI risk score for STEMI was significantly higher in patients with MACE compared to without MACE ( 16.95, SD 1.78 versus 3.00, SD 1.10; p<0.001) respectively. Conclusion: From the study we conclude that TIMI risk score (5 or above) is a reliable tool in ............