TY - JOUR
T1 - Usefulness of the TIMI risk score in predicting both short- and long-term outcomes in the Veterans Affairs Non-Q-Wave Myocardial Infarction Strategies In-Hospital (VANQWISH) Trial
AU - Samaha, Frederick F.
AU - Kimmel, Stephen E.
AU - Kizer, Jorge R.
AU - Goyal, Abhinav
AU - Wade, Michael
AU - Boden, William E.
PY - 2002/11/1
Y1 - 2002/11/1
N2 - We sought to test the validity and clinical utility of the Thrombolysis In Myocardial Infarction (TIMI) risk score for patients who have non-Q-wave myocardial infarction. A post hoc analysis of the Veterans Affairs Non-Q-Wave Infarction Strategies In-Hospital (VANQWISH) Trial was performed, wherein patients were assigned a TIMI risk score from which both 30-day and 12-month outcomes (death, nonfatal myocardial infarction, or urgent revascularization) were assessed. At 30 days, the TIMI risk score showed a close match between observed and predicted probabilities of events after adjustment for overall event rates. The event rate at 30 days was 6% for a score of 0 to 2, 10% for a score of 3, 13% for a score of 4, and 14% for a score of 5 to 7 (p = 0.003 and c statistic 0.59). Discriminative ability of the score was greater in the conservative group at 30 days (p = 0.0004, c statistic 0.67). The score remained modestly predictive of events at 1 year (c statistic 0.60). Conservative strategy patients had better 30-day outcomes than the invasive strategy patients if their score was 0 to 2 (odds ratio 0.24, 95% confidence interval 0.08 to 0.76). No significant difference in outcomes between strategies was detected for a score ≥3. The TIMI risk score provides moderate incremental prognostic information in high-risk patients, during both short- and long-term follow-up.
AB - We sought to test the validity and clinical utility of the Thrombolysis In Myocardial Infarction (TIMI) risk score for patients who have non-Q-wave myocardial infarction. A post hoc analysis of the Veterans Affairs Non-Q-Wave Infarction Strategies In-Hospital (VANQWISH) Trial was performed, wherein patients were assigned a TIMI risk score from which both 30-day and 12-month outcomes (death, nonfatal myocardial infarction, or urgent revascularization) were assessed. At 30 days, the TIMI risk score showed a close match between observed and predicted probabilities of events after adjustment for overall event rates. The event rate at 30 days was 6% for a score of 0 to 2, 10% for a score of 3, 13% for a score of 4, and 14% for a score of 5 to 7 (p = 0.003 and c statistic 0.59). Discriminative ability of the score was greater in the conservative group at 30 days (p = 0.0004, c statistic 0.67). The score remained modestly predictive of events at 1 year (c statistic 0.60). Conservative strategy patients had better 30-day outcomes than the invasive strategy patients if their score was 0 to 2 (odds ratio 0.24, 95% confidence interval 0.08 to 0.76). No significant difference in outcomes between strategies was detected for a score ≥3. The TIMI risk score provides moderate incremental prognostic information in high-risk patients, during both short- and long-term follow-up.
UR - http://www.scopus.com/inward/record.url?scp=0036829419&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036829419&partnerID=8YFLogxK
U2 - 10.1016/S0002-9149(02)02654-1
DO - 10.1016/S0002-9149(02)02654-1
M3 - Article
C2 - 12398955
AN - SCOPUS:0036829419
SN - 0002-9149
VL - 90
SP - 922
EP - 926
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 9
ER -