Key result
High pre-admission TIMI Risk Index is linked to increased no-reflow, MACE, and mortality in STEMI.
Why the study?
Risk assessment tools including TIMI Risk Index (TRI) have been used to evaluate risk in ACS patients, but their value in predicting no-reflow phenomenon after primary PCI in STEMI patients was investigated in this study.
Observational (n=319)
Supports further evaluation of TIMI Risk Index for STEMI risk stratification; hypothesis-generating and should not yet change practice.
Background: Coronary artery disease and acute coronary syndrome (ACS) are the major causes of death, worldwide. Risk assessment for patients with ACS is necessary to minimize morbidity and mortality. The global registry of acute coronary events risk score (GRS), the in thrombolysis myocardial infarction (TIMI) risk score (TRS), and the TIMI risk index (TRI) have been used for patients with ACS to evaluate their risk. We showed at our study the value of pre-admission TRI, TRS, and GRS in occurrence prediction of no-reflow (NRF) Phenomenon after primary PCI for ST-elevation myocardial infarction (STEMI) patients; and its impact on the in-hospital outcome for those patients. Patients and Methods: Our study included 319 patients presented with STEMI and managed by primary PCI. For all patients, we recorded a detailed history, clinical examination as well as Killip class, electrocardiogram, and echocardiography. TRI as well, TRS, and GRS were calculated for all patients. We observed all patients during their PCI at the catheterization room to monitor the result of the intervention. NRF was defined as TIMI flow grade less than III or TIMI flow Grade III with myocardial blush grade less than or equal to II. Then, we followed the patients during their hospitalization period to record any associated complications and mortality. Results: We found NRF patients older than reflow patients, thus regarding age. They were more males. Killip Class III-IV was found to be more common in NRF patients. TRI as well, TRS and GRS showed higher values among the NRF patients. As well, in-hospital major adverse cardiac events (MACEs) and mortality were more common in NRF patients. Conclusion: We found that the high TRI values were related to the occurrence of NRF, in hospital MACE, and mortality.
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Elhafeez et al. (2018) conducted an observational in ST Segment Elevation Myocardial Infarction (STEMI) (n=319). Thrombolysis in Myocardial Infarction (TIMI) Risk Index (TRI) vs. Lower risk scores was evaluated on Occurrence of no-reflow (NRF) phenomenon after primary PCI. High pre-admission TIMI Risk Index values were associated with an increased occurrence of no-reflow phenomenon, in-hospital major adverse cardiac events, and mortality in STEMI patients.
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