Značaj TIMI skora kod bolesnika sa akutnim infarktom miokarda sa ST elevacijom

Abstract

Background: The prognosis of patients with acute coronary syndrome (ACS) can be determined on the basis of the TIMI risk score, which is one of the scores easily applicable for quantitative risk assessment of patients. The primary objective of this paper is to assess whether the TIMI risk score significant predictor of poor outcome in our patients with STEMI, within the first month and within the first year of monitoring. A secondary aim of the study is the correlation TIMI score and ejection fraction (EF), wall motion score index (WMSI) and infarct size in the same patients during the early post-infarction period. Method: The study included 115 patients with STEMI, age 56.6 ± 10.2 years, 79 men and 36 women, who were hospitalized in the coronary care unit of CCS. TIMI risk score was calculated for all patients and based on: patient's age, previous risk factors (diabetes, hypertension and angina pectoris), and systolic blood pressure on admission rate, Killip class, weight, presence of ST elevation on the front wall or left bundle branch block and the time of onset of symptoms. Echocardiography was done within 7 days of myocardial infarction and parameters EF and WMSI were determined. Infarct size was estimated based on the maximum levels of creatine kinase (CK). Patients were followed at regular check-ups for a period of one year. Results: The cut-off value of the TIMI risk score in patients with STEMI was 4.5 with a very high specificity 85.7 % and sensitivity 81.1 %. TIMI risk score is a significant predictor of poor outcome in a one-month (RR 1.57, 95 % CI 1.28 to 1.93, p <0.001), and one-year follow-up period (RR 1.52, 95 % CI 1.25 to 1.84, p <0.001). A significant correlation was found between the TIMI score and EF (47.83 % ± 8.28 %), p = 0.001, and between the TIMI score and WMSI (1.25 ± 0.22), p = 0.003 in the early post-infarction period. Conclusion: TIMI score in STEMI patients calculated after patient admission to the CCU is one of the easily applicable and reliable scores for the quantitative assessment of risk for poor outcome within the first month and within the first year of the disease. Also, the TIMI score correlate with parameters of systolic left ventricular function in these patients.