ST elevation myocardial infarction risk stratification and prognosis: Difference between revisions
| Line 67: | Line 67: | ||
|} | |} | ||
==GRACE Risk Score== | |||
*The [[GRACE|Global Registry of Acute Coronary Events (GRACE)]] risk score for [[ACS]]: | *The [[GRACE|Global Registry of Acute Coronary Events (GRACE)]] risk score for [[ACS]]: | ||
** | **[[The GRACE risk score]] was created from a multivariable [[logistic regression]] model using [[ACS]] patients enrolled in the [[GRACE]] registry (N=11389). | ||
** | **[[The GRACE risk score]] was validated using subsequent [[cohort]] of patients enrolled in [[GRACE]] (n=3972) and the [[GUSTO|Global Use of Strategies to Open Occluded Coronary Arteries IIb (GUSTO-IIb)]] trial (n=12142). | ||
* The [[Acute Coronary Syndrome risk stratification|AHA/ACCA Guidelines for Unstable Angina/Non -ST-Elevation Myocardial Infarction]] provide guidelines for risk stratification for [[ACS]]. | * The [[Acute Coronary Syndrome risk stratification|AHA/ACCA Guidelines for Unstable Angina/Non -ST-Elevation Myocardial Infarction]] provide guidelines for risk stratification for [[ACS]]. | ||
Revision as of 17:02, 8 May 2014
|
ST Elevation Myocardial Infarction Microchapters |
|
Differentiating ST elevation myocardial infarction from other Diseases |
|
Diagnosis |
|
Treatment |
|
|
Case Studies |
|
ST elevation myocardial infarction risk stratification and prognosis On the Web |
|
FDA on ST elevation myocardial infarction risk stratification and prognosis |
|
CDC on ST elevation myocardial infarction risk stratification and prognosis |
|
ST elevation myocardial infarction risk stratification and prognosis in the news |
|
Blogs on ST elevation myocardial infarction risk stratification and prognosis |
|
Directions to Hospitals Treating ST elevation myocardial infarction |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Two main risk-stratification scores are used when assessing a patient with ST elevation MI and acute coronary syndromes; the TIMI Risk Score (for STEMI), and the GRACE risk score (for acute coronary syndrome.
The TIMI Risk Score
The TIMI risk score for STEMI was created from simple arithmetic sum of independent predictors of mortality weighted according to the adjusted odds ratios from logistic regression analysis. The risk score was derived from 14,114 patients enrolled in the Intravenous nPA for Treatment of Infarcting Myocardium Early II trial (TIME II). The TIMI risk score was subsequently validated in an unselected heterogeneous community population through the National Registry of Myocardial Infarction (NRMI) 3 & 4.
The TIMI risk score for TIMI is calculated by adding the numbers assigned to the different criteria shown below. The total possible score is 14.[1]
| Risk Factor | Points |
| Demographic data and medical history | |
| Age ≥75 years | 3 |
| Age 65–74 years | 2 |
| History of diabetes mellitus or hypertension or angina | 1 |
| Physical examination | |
| Systolic blood pressure <100 | 3 |
| Heart rate >100 | 2 |
| Killip class II–IV | 2 |
| Weight <67 kg | 1 |
| Evaluation at presentation | |
| Anterior ST elevation or left bundle branch block | 1 |
| Time to therapy >4 hours | 1 |
Interpretation of TIMI Risk Score for STEMI
| Score | 30 Day Mortality (%)[1] |
| 0 | 0.8% |
| 1 | 1.6% |
| 2 | 2.2% |
| 3 | 4.4% |
| 4 | 7.3% |
| 5 | 12.4% |
| 6 | 16.1% |
| 7 | 23.4% |
| 8 | 26.8% |
| >8 | 35.9% |
GRACE Risk Score
- The Global Registry of Acute Coronary Events (GRACE) risk score for ACS:
- The GRACE risk score was created from a multivariable logistic regression model using ACS patients enrolled in the GRACE registry (N=11389).
- The GRACE risk score was validated using subsequent cohort of patients enrolled in GRACE (n=3972) and the Global Use of Strategies to Open Occluded Coronary Arteries IIb (GUSTO-IIb) trial (n=12142).
- The AHA/ACCA Guidelines for Unstable Angina/Non -ST-Elevation Myocardial Infarction provide guidelines for risk stratification for ACS.
References
- ↑ 1.0 1.1 Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA; et al. (2000). "TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy". Circulation. 102 (17): 2031–7. PMID 11044416.