IN-HOSPITAL OUTCOME OF ACUTE MYOCARDIAL INFARCTION IN CORRELATION WITH '˜THROMBOLYSIS IN MYOCARDIAL INFARCTION' RISK SCORE
Abstract
Background: Effective risk stratification is integral to management of acute coronary syndromes(ACS). The Thrombolysis in Myocardial Infarction (TIMI) risk score for ST-segment elevation
myocardial infarction (STEMI) is a simple integer score based on 8 high-risk parameters that can
be used at the bedside for risk stratification of patients at presentation with STEMI. Objectives:
To evaluate the prognostic significance of TIMI risk score in a local population group of acute
STEMI. Material and Methods: The study included 160 cases of STEMI eligible for
thrombolysis. TIMI risk score was calculated for each case at the time of presentation and were
then followed during their hospital stay for the occurrence of electrical and mechanical
complications as well as mortality. The patients were divided into three risk groups, namely '˜lowrisk', '˜moderate-risk' and '˜high-risk' based on their TIMI scores (0-4 low-risk, 5-8 moderate-risk,
9-14 high risk). The frequencies of complications and deaths were compared among the three risk
groups. Results: Post MI arrhythmias were noted in 2.2%, 16% and 50%; cardiogenic shock in
6.7%, 16% and 60%; pulmonary edema in 6.7%, 20% and 80%; mechanical complications of MI
in 0%, 8% and 30%; death in 4.4%, 8%, and 60% of patients belonging to low-risk, moderate-risk
and high-risk groups respectively. Frequency of complications and death correlated well with
TIMI risk score (p=0.001). Conclusion: TIMI risk score correlates well with the frequency of
electrical or mechanical complications and death after STEMI.
Keywords: ST elevation MI, Acute Myocardial infarction, Ischemic heart disease
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