TIMI risk score for secondary prevention of recurrent cardiovascular events in a real-world cohort of post-non-ST-elevation myocardial infarction patients
BackgroundPatients who survive non-ST-elevation myocardial infarction (NSTEMI) are at heightened risk of recurrent cardiovascular events. Data on long-term secondary atherothrombotic risk stratification are limited.ObjectivesTo stratify post-NSTEMI patients for risk of recurrent cardiovascular event...
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| Veröffentlicht in: | Postgraduate medical journal 2019-07, Vol.95 (1125), p.372-377 |
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| creator | Huang, Duo Cheng, Yang Yang Wong, Yiu Tung Yung, See Yue Chan, Ki Wan Lam, Cheung Chi Hai, JoJo Lau, Chu Pak Wong, Ka Lam Feng, Ying Qing Tan, Ning Chen, Ji Yan Wu, Ming Xiang Su, Xi Yan, Hua Song, Dan Tse, Hung Fat Chan, Pak Hei Siu, Chung Wah Tam, Chor Cheung |
| description | BackgroundPatients who survive non-ST-elevation myocardial infarction (NSTEMI) are at heightened risk of recurrent cardiovascular events. Data on long-term secondary atherothrombotic risk stratification are limited.ObjectivesTo stratify post-NSTEMI patients for risk of recurrent cardiovascular events to maximise benefit from aggressive secondary prevention strategies using the TIMI Risk Score for Secondary Prevention (TRS 2°P) score in a real-world cohort of NSTEMI patients.Methods and resultsThis was a single-centre observational study of 891 post-NSTEMI patients (73.7 ± 12.7 years; male: 54.2%). The TRS 2°P is a nine-point risk stratification tool to predict cardiovascular events in patients with established cardiovascular disease. The primary outcome was a composite endpoint of cardiovascular death, non-fatal MI and non-fatal ischaemic stroke. After a median follow-up of 31 months (IQR: 11.4 – 60.2), 281 patients (31.5%) had developed a primary outcome (13.3%/year) including 196 cardiovascular deaths, 94 non-fatal MIs and 22 non-fatal strokes. The TRS 2°P score was strongly associated with the primary outcome. The annual incidence of primary composite endpoint for patients with TRS 2°P score =0 was 1.6%, and increased progressively to 47.4% for those with a TRS 2°P score ≥6 (HR: 20.18, 95% CI: 4.85 to 84.05, p |
| doi_str_mv | 10.1136/postgradmedj-2019-136404 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2232136643</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2232136643</sourcerecordid><originalsourceid>FETCH-LOGICAL-b437t-5124620dfc659289f651960336a6aae5407f8a5848dc02731944e7231dad3f6f3</originalsourceid><addsrcrecordid>eNqNkc1u1DAUhS1URKeFV0CW2HRj6n8nS1S1MFKrLhjWkcc_kCGJw3UyVV-Fp8WZKQh1VcmS5Xu_c3ztgxBm9CNjQl-OKU_fwfo--B3hlNWkVCWVr9CKSV0TapQ-QStKBSdKGnGKznLeUcqEkewNOhWMccGMXKHfm_XdGkObf-LsEgQcE-AcXBq8hUc8QtiHYWrTgFPEENwMUM7YWfBt2tvs5s4CPkAZtwO2BbIdeUjQeezSjwTTolwGJkMayNcNCV3Y24Nl_5gORrYr0mjBHapjaS52b9HraLsc3j3t5-jbzfXm6gu5vf-8vvp0S7ZSmIkoxqXm1EenVc2rOmrFak2F0FZbG5SkJlZWVbLyjnIjWC1lMOX53noRdRTn6OLoO0L6NYc8NX2bXeg6O4Q054Zzwcv3aikK-uEZukszDGW6QilRllGmUNWRcpByhhCbEdq-fGfDaLPk1_yfX7Pk1xzzK9L3TxfM29L8J_wbWAHEEdj2u5fb_gEXh60g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2253253757</pqid></control><display><type>article</type><title>TIMI risk score for secondary prevention of recurrent cardiovascular events in a real-world cohort of post-non-ST-elevation myocardial infarction patients</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Huang, Duo ; Cheng, Yang Yang ; Wong, Yiu Tung ; Yung, See Yue ; Chan, Ki Wan ; Lam, Cheung Chi ; Hai, JoJo ; Lau, Chu Pak ; Wong, Ka Lam ; Feng, Ying Qing ; Tan, Ning ; Chen, Ji Yan ; Wu, Ming Xiang ; Su, Xi ; Yan, Hua ; Song, Dan ; Tse, Hung Fat ; Chan, Pak Hei ; Siu, Chung Wah ; Tam, Chor Cheung</creator><creatorcontrib>Huang, Duo ; Cheng, Yang Yang ; Wong, Yiu Tung ; Yung, See Yue ; Chan, Ki Wan ; Lam, Cheung Chi ; Hai, JoJo ; Lau, Chu Pak ; Wong, Ka Lam ; Feng, Ying Qing ; Tan, Ning ; Chen, Ji Yan ; Wu, Ming Xiang ; Su, Xi ; Yan, Hua ; Song, Dan ; Tse, Hung Fat ; Chan, Pak Hei ; Siu, Chung Wah ; Tam, Chor Cheung</creatorcontrib><description>BackgroundPatients who survive non-ST-elevation myocardial infarction (NSTEMI) are at heightened risk of recurrent cardiovascular events. Data on long-term secondary atherothrombotic risk stratification are limited.ObjectivesTo stratify post-NSTEMI patients for risk of recurrent cardiovascular events to maximise benefit from aggressive secondary prevention strategies using the TIMI Risk Score for Secondary Prevention (TRS 2°P) score in a real-world cohort of NSTEMI patients.Methods and resultsThis was a single-centre observational study of 891 post-NSTEMI patients (73.7 ± 12.7 years; male: 54.2%). The TRS 2°P is a nine-point risk stratification tool to predict cardiovascular events in patients with established cardiovascular disease. The primary outcome was a composite endpoint of cardiovascular death, non-fatal MI and non-fatal ischaemic stroke. After a median follow-up of 31 months (IQR: 11.4 – 60.2), 281 patients (31.5%) had developed a primary outcome (13.3%/year) including 196 cardiovascular deaths, 94 non-fatal MIs and 22 non-fatal strokes. The TRS 2°P score was strongly associated with the primary outcome. The annual incidence of primary composite endpoint for patients with TRS 2°P score =0 was 1.6%, and increased progressively to 47.4% for those with a TRS 2°P score ≥6 (HR: 20.18, 95% CI: 4.85 to 84.05, p<0.001). Similar associations were also observed between the TRS 2°P score and cardiovascular death and MI (fatal and non-fatal), but not non-fatal ischaemic stroke.ConclusionThe TRS 2°P score stratified post-NSTEMI patients for risk of future cardiovascular events and potentially help guide the selection of more aggressive secondary prevention therapy.</description><identifier>ISSN: 0032-5473</identifier><identifier>EISSN: 1469-0756</identifier><identifier>DOI: 10.1136/postgradmedj-2019-136404</identifier><identifier>PMID: 31123174</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Academic Medical Centers ; Acute Coronary Syndrome - mortality ; Acute Coronary Syndrome - prevention & control ; Acute coronary syndromes ; Aged ; Aged, 80 and over ; Brain Ischemia - etiology ; Brain Ischemia - prevention & control ; Cardiac arrhythmia ; Cardiology ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - prevention & control ; Cause of Death ; Coronary vessels ; Diabetes ; Disease prevention ; Female ; Health risk assessment ; Heart attacks ; Heart failure ; Hong Kong ; Hospitals ; Humans ; Hypertension ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mortality ; Non-ST Elevated Myocardial Infarction - diagnostic imaging ; Non-ST Elevated Myocardial Infarction - mortality ; Non-ST Elevated Myocardial Infarction - therapy ; Outpatient care facilities ; Predictive Value of Tests ; Recurrence ; Registries ; Retrospective Studies ; Risk Assessment ; Secondary Prevention - methods ; Stroke ; Stroke - etiology ; Stroke - prevention & control ; Survival Analysis ; Survivors</subject><ispartof>Postgraduate medical journal, 2019-07, Vol.95 (1125), p.372-377</ispartof><rights>Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2019 Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b437t-5124620dfc659289f651960336a6aae5407f8a5848dc02731944e7231dad3f6f3</citedby><cites>FETCH-LOGICAL-b437t-5124620dfc659289f651960336a6aae5407f8a5848dc02731944e7231dad3f6f3</cites><orcidid>0000-0003-4159-7635</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31123174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Duo</creatorcontrib><creatorcontrib>Cheng, Yang Yang</creatorcontrib><creatorcontrib>Wong, Yiu Tung</creatorcontrib><creatorcontrib>Yung, See Yue</creatorcontrib><creatorcontrib>Chan, Ki Wan</creatorcontrib><creatorcontrib>Lam, Cheung Chi</creatorcontrib><creatorcontrib>Hai, JoJo</creatorcontrib><creatorcontrib>Lau, Chu Pak</creatorcontrib><creatorcontrib>Wong, Ka Lam</creatorcontrib><creatorcontrib>Feng, Ying Qing</creatorcontrib><creatorcontrib>Tan, Ning</creatorcontrib><creatorcontrib>Chen, Ji Yan</creatorcontrib><creatorcontrib>Wu, Ming Xiang</creatorcontrib><creatorcontrib>Su, Xi</creatorcontrib><creatorcontrib>Yan, Hua</creatorcontrib><creatorcontrib>Song, Dan</creatorcontrib><creatorcontrib>Tse, Hung Fat</creatorcontrib><creatorcontrib>Chan, Pak Hei</creatorcontrib><creatorcontrib>Siu, Chung Wah</creatorcontrib><creatorcontrib>Tam, Chor Cheung</creatorcontrib><title>TIMI risk score for secondary prevention of recurrent cardiovascular events in a real-world cohort of post-non-ST-elevation myocardial infarction patients</title><title>Postgraduate medical journal</title><addtitle>Postgrad Med J</addtitle><description>BackgroundPatients who survive non-ST-elevation myocardial infarction (NSTEMI) are at heightened risk of recurrent cardiovascular events. Data on long-term secondary atherothrombotic risk stratification are limited.ObjectivesTo stratify post-NSTEMI patients for risk of recurrent cardiovascular events to maximise benefit from aggressive secondary prevention strategies using the TIMI Risk Score for Secondary Prevention (TRS 2°P) score in a real-world cohort of NSTEMI patients.Methods and resultsThis was a single-centre observational study of 891 post-NSTEMI patients (73.7 ± 12.7 years; male: 54.2%). The TRS 2°P is a nine-point risk stratification tool to predict cardiovascular events in patients with established cardiovascular disease. The primary outcome was a composite endpoint of cardiovascular death, non-fatal MI and non-fatal ischaemic stroke. After a median follow-up of 31 months (IQR: 11.4 – 60.2), 281 patients (31.5%) had developed a primary outcome (13.3%/year) including 196 cardiovascular deaths, 94 non-fatal MIs and 22 non-fatal strokes. The TRS 2°P score was strongly associated with the primary outcome. The annual incidence of primary composite endpoint for patients with TRS 2°P score =0 was 1.6%, and increased progressively to 47.4% for those with a TRS 2°P score ≥6 (HR: 20.18, 95% CI: 4.85 to 84.05, p<0.001). Similar associations were also observed between the TRS 2°P score and cardiovascular death and MI (fatal and non-fatal), but not non-fatal ischaemic stroke.ConclusionThe TRS 2°P score stratified post-NSTEMI patients for risk of future cardiovascular events and potentially help guide the selection of more aggressive secondary prevention therapy.</description><subject>Academic Medical Centers</subject><subject>Acute Coronary Syndrome - mortality</subject><subject>Acute Coronary Syndrome - prevention & control</subject><subject>Acute coronary syndromes</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Brain Ischemia - etiology</subject><subject>Brain Ischemia - prevention & control</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - mortality</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Cause of Death</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>Disease prevention</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hong Kong</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Non-ST Elevated Myocardial Infarction - diagnostic imaging</subject><subject>Non-ST Elevated Myocardial Infarction - mortality</subject><subject>Non-ST Elevated Myocardial Infarction - therapy</subject><subject>Outpatient care facilities</subject><subject>Predictive Value of Tests</subject><subject>Recurrence</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Secondary Prevention - methods</subject><subject>Stroke</subject><subject>Stroke - etiology</subject><subject>Stroke - prevention & control</subject><subject>Survival Analysis</subject><subject>Survivors</subject><issn>0032-5473</issn><issn>1469-0756</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkc1u1DAUhS1URKeFV0CW2HRj6n8nS1S1MFKrLhjWkcc_kCGJw3UyVV-Fp8WZKQh1VcmS5Xu_c3ztgxBm9CNjQl-OKU_fwfo--B3hlNWkVCWVr9CKSV0TapQ-QStKBSdKGnGKznLeUcqEkewNOhWMccGMXKHfm_XdGkObf-LsEgQcE-AcXBq8hUc8QtiHYWrTgFPEENwMUM7YWfBt2tvs5s4CPkAZtwO2BbIdeUjQeezSjwTTolwGJkMayNcNCV3Y24Nl_5gORrYr0mjBHapjaS52b9HraLsc3j3t5-jbzfXm6gu5vf-8vvp0S7ZSmIkoxqXm1EenVc2rOmrFak2F0FZbG5SkJlZWVbLyjnIjWC1lMOX53noRdRTn6OLoO0L6NYc8NX2bXeg6O4Q054Zzwcv3aikK-uEZukszDGW6QilRllGmUNWRcpByhhCbEdq-fGfDaLPk1_yfX7Pk1xzzK9L3TxfM29L8J_wbWAHEEdj2u5fb_gEXh60g</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Huang, Duo</creator><creator>Cheng, Yang Yang</creator><creator>Wong, Yiu Tung</creator><creator>Yung, See Yue</creator><creator>Chan, Ki Wan</creator><creator>Lam, Cheung Chi</creator><creator>Hai, JoJo</creator><creator>Lau, Chu Pak</creator><creator>Wong, Ka Lam</creator><creator>Feng, Ying Qing</creator><creator>Tan, Ning</creator><creator>Chen, Ji Yan</creator><creator>Wu, Ming Xiang</creator><creator>Su, Xi</creator><creator>Yan, Hua</creator><creator>Song, Dan</creator><creator>Tse, Hung Fat</creator><creator>Chan, Pak Hei</creator><creator>Siu, Chung Wah</creator><creator>Tam, Chor Cheung</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4159-7635</orcidid></search><sort><creationdate>20190701</creationdate><title>TIMI risk score for secondary prevention of recurrent cardiovascular events in a real-world cohort of post-non-ST-elevation myocardial infarction patients</title><author>Huang, Duo ; Cheng, Yang Yang ; Wong, Yiu Tung ; Yung, See Yue ; Chan, Ki Wan ; Lam, Cheung Chi ; Hai, JoJo ; Lau, Chu Pak ; Wong, Ka Lam ; Feng, Ying Qing ; Tan, Ning ; Chen, Ji Yan ; Wu, Ming Xiang ; Su, Xi ; Yan, Hua ; Song, Dan ; Tse, Hung Fat ; Chan, Pak Hei ; Siu, Chung Wah ; Tam, Chor Cheung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b437t-5124620dfc659289f651960336a6aae5407f8a5848dc02731944e7231dad3f6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Academic Medical Centers</topic><topic>Acute Coronary Syndrome - mortality</topic><topic>Acute Coronary Syndrome - prevention & control</topic><topic>Acute coronary syndromes</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Brain Ischemia - etiology</topic><topic>Brain Ischemia - prevention & control</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cardiovascular Diseases - mortality</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Cause of Death</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>Disease prevention</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Hong Kong</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Non-ST Elevated Myocardial Infarction - diagnostic imaging</topic><topic>Non-ST Elevated Myocardial Infarction - mortality</topic><topic>Non-ST Elevated Myocardial Infarction - therapy</topic><topic>Outpatient care facilities</topic><topic>Predictive Value of Tests</topic><topic>Recurrence</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Secondary Prevention - methods</topic><topic>Stroke</topic><topic>Stroke - etiology</topic><topic>Stroke - prevention & control</topic><topic>Survival Analysis</topic><topic>Survivors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Duo</creatorcontrib><creatorcontrib>Cheng, Yang Yang</creatorcontrib><creatorcontrib>Wong, Yiu Tung</creatorcontrib><creatorcontrib>Yung, See Yue</creatorcontrib><creatorcontrib>Chan, Ki Wan</creatorcontrib><creatorcontrib>Lam, Cheung Chi</creatorcontrib><creatorcontrib>Hai, JoJo</creatorcontrib><creatorcontrib>Lau, Chu Pak</creatorcontrib><creatorcontrib>Wong, Ka Lam</creatorcontrib><creatorcontrib>Feng, Ying Qing</creatorcontrib><creatorcontrib>Tan, Ning</creatorcontrib><creatorcontrib>Chen, Ji Yan</creatorcontrib><creatorcontrib>Wu, Ming Xiang</creatorcontrib><creatorcontrib>Su, Xi</creatorcontrib><creatorcontrib>Yan, Hua</creatorcontrib><creatorcontrib>Song, Dan</creatorcontrib><creatorcontrib>Tse, Hung Fat</creatorcontrib><creatorcontrib>Chan, Pak Hei</creatorcontrib><creatorcontrib>Siu, Chung Wah</creatorcontrib><creatorcontrib>Tam, Chor Cheung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Postgraduate medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Duo</au><au>Cheng, Yang Yang</au><au>Wong, Yiu Tung</au><au>Yung, See Yue</au><au>Chan, Ki Wan</au><au>Lam, Cheung Chi</au><au>Hai, JoJo</au><au>Lau, Chu Pak</au><au>Wong, Ka Lam</au><au>Feng, Ying Qing</au><au>Tan, Ning</au><au>Chen, Ji Yan</au><au>Wu, Ming Xiang</au><au>Su, Xi</au><au>Yan, Hua</au><au>Song, Dan</au><au>Tse, Hung Fat</au><au>Chan, Pak Hei</au><au>Siu, Chung Wah</au><au>Tam, Chor Cheung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>TIMI risk score for secondary prevention of recurrent cardiovascular events in a real-world cohort of post-non-ST-elevation myocardial infarction patients</atitle><jtitle>Postgraduate medical journal</jtitle><addtitle>Postgrad Med J</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>95</volume><issue>1125</issue><spage>372</spage><epage>377</epage><pages>372-377</pages><issn>0032-5473</issn><eissn>1469-0756</eissn><abstract>BackgroundPatients who survive non-ST-elevation myocardial infarction (NSTEMI) are at heightened risk of recurrent cardiovascular events. Data on long-term secondary atherothrombotic risk stratification are limited.ObjectivesTo stratify post-NSTEMI patients for risk of recurrent cardiovascular events to maximise benefit from aggressive secondary prevention strategies using the TIMI Risk Score for Secondary Prevention (TRS 2°P) score in a real-world cohort of NSTEMI patients.Methods and resultsThis was a single-centre observational study of 891 post-NSTEMI patients (73.7 ± 12.7 years; male: 54.2%). The TRS 2°P is a nine-point risk stratification tool to predict cardiovascular events in patients with established cardiovascular disease. The primary outcome was a composite endpoint of cardiovascular death, non-fatal MI and non-fatal ischaemic stroke. After a median follow-up of 31 months (IQR: 11.4 – 60.2), 281 patients (31.5%) had developed a primary outcome (13.3%/year) including 196 cardiovascular deaths, 94 non-fatal MIs and 22 non-fatal strokes. The TRS 2°P score was strongly associated with the primary outcome. The annual incidence of primary composite endpoint for patients with TRS 2°P score =0 was 1.6%, and increased progressively to 47.4% for those with a TRS 2°P score ≥6 (HR: 20.18, 95% CI: 4.85 to 84.05, p<0.001). Similar associations were also observed between the TRS 2°P score and cardiovascular death and MI (fatal and non-fatal), but not non-fatal ischaemic stroke.ConclusionThe TRS 2°P score stratified post-NSTEMI patients for risk of future cardiovascular events and potentially help guide the selection of more aggressive secondary prevention therapy.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31123174</pmid><doi>10.1136/postgradmedj-2019-136404</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-4159-7635</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Academic Medical Centers Acute Coronary Syndrome - mortality Acute Coronary Syndrome - prevention & control Acute coronary syndromes Aged Aged, 80 and over Brain Ischemia - etiology Brain Ischemia - prevention & control Cardiac arrhythmia Cardiology Cardiovascular Diseases - etiology Cardiovascular Diseases - mortality Cardiovascular Diseases - prevention & control Cause of Death Coronary vessels Diabetes Disease prevention Female Health risk assessment Heart attacks Heart failure Hong Kong Hospitals Humans Hypertension Kaplan-Meier Estimate Male Middle Aged Mortality Non-ST Elevated Myocardial Infarction - diagnostic imaging Non-ST Elevated Myocardial Infarction - mortality Non-ST Elevated Myocardial Infarction - therapy Outpatient care facilities Predictive Value of Tests Recurrence Registries Retrospective Studies Risk Assessment Secondary Prevention - methods Stroke Stroke - etiology Stroke - prevention & control Survival Analysis Survivors |
| title | TIMI risk score for secondary prevention of recurrent cardiovascular events in a real-world cohort of post-non-ST-elevation myocardial infarction patients |
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