A PROSPECTIVE OBSERVATIONAL STUDY ON RISK ASSESSMENT OF STEMI PATIENTS AT A TERTIARY CARE HOSPITAL
Keywords:
Timi, Dtimi, Risk Assessment, Stratification, Non-Stmi, Stmi, Risk FactorsAbstract
Objectives: To estimate risk of mortality and morbidity of STEMI patients at admission and discharge time. One objective includes comparing the lipid profile in STEMI patients and healthy subjects to establish the relation between the risk factor.
Methods: A prospective observational study was conducted from January 2013 to September 2013. We included 80 patients in the study group and 50 healthy subjects in the control group to assess the risk in STEMI patients using the dynamic TIMI risk score. Serum lipid levels were measured in these patients by (CC3300) cholesterol analyzer.
Results: The study group consists of 80 patients and 50 controls. Our results show the significant correlation of hospital events with a dynamic TIMI risk score. In addition to that we observed that highly significant HDL,LDL levels at p-value <0.0001 and Triglycerides were less significant with p-value <0.038. Dynamic TIMI risk score estimate 1-year mortality at discharge time.
Conclusion: The Dynamic TIMI risk score applied to STEMI patients, identifies a group of patients at high risk and this should be a continuous process, as over the time patients condition can change.
Â
Downloads
References
Killip T, Kimball JT. Treatment of myocardial infarction in a coronary care unit A two year experience with 250 patients". Am J Cardiol 2000;4:457–64.
Gupta R. Recent trends in coronary heart disease epidemiology in India, Indian Heart J 2008;60(2):18.
Collet JP, Montalescot G, Vicaut E, Ankri A, Walylo F, Lesty C, et al. Acute release of plasminogen activator inhibitor-1 in st-segment elevation myocardial infarction predicts mortality. Circulation 2003;108:391-4.
Goldman L, Cook EF, Brand DA, Lee TH, Rouan GW, Weisberg MC, et al. A computer protocol to predict myocardial infarction in emergency department patients with chest pain. N Engl J Med 1988;318:797-803.
Pozen MW, d’Agostino RB, Selker HP, Sytkowski PA, Hood WB Jr. A predictive instrument to improve coronary-care-unit admission practices in acute ischemic heart disease. A prospective multicenter clinical trial. N Engl J Med 1984;310:1273-8.
Bayón FJ, AlegrÃa EE, Bosch X, Cabadés OA, Iglesias I, Jiménez Nacher JJ, et al. Unidades de dolor torácico. Organización y protocol para el diagnóstico de los sÃndromes coronarios agudos. Rev Esp Cardiol 2002;55:143-54.
Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshansky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med 2000;342:1163-70.
Fibrinolytic Therapy Trialists’ Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction. Lancet 1994;343:311–22.
Rouleau JL, Talajic M, Sussex B, Potvin L, Warnica W, Davies RF, et al. Myocardial infarction patients in the 1990s: their risk factors, stratification and survival in canada: the canadian assessment of myocardial infarction (CAMI) study. J Am Coll Cardiol 1996;27:1119–27.
Pope JH, Aufderheide TP, Ruthazer R, Woolard RH, Feldman JA, Beshansky JR, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med 2000;342:1163-70.
Aimahmeed, Bita Omidvar, Fazlolah Ayatollahi, Mohammad Alasti. Serum uric acid as a prognostic biomarker and its correlation with killip class in acute myocardial infarction. J Saudi Heart Assoc 2012;24(2):73–8.
Lal C Daga, Upendra Kaul, Aijaz Mansoor. Approach to STEMI and NSTEMI. Suppl Japi 2011;59:19-25.
Escosteguy CC, Portela MC, Medronho RA, Vasconcellos MTL. Infarto agudo do miocárdio: perfil clÃnico-epidemiológico e fatores associados ao óbito ospitalar no municÃpio do rio de janeiro. Arq Bras Cardiol 2003;80(6):593-9.
Ambulance service of NSW. Excellence in care DEC; 2009.
Khan MR. Extent of ST segment depression predicts in-hospital outcome in non ST segment elevation in acute coronary syndrome. National institute of cardiovascular disease, Dhaka, Bangladesh. Thesis (Md. cardiology); 2008.
Héctor González-Pacheco. The TIMI risk score for STEMI predicts in-hospital mortality and adverse events in patients without cardiogenic shock undergoing primary angioplasty. Arch Cardiol Mex 2012;82(1):7-13.
Sameer T Amin, David A Morrow, Eugene Braunwald, Sarah Sloan, Charles Contant, Sabina Murphy, et al. Dynamic timi for stem. J Am Heart Assoc 2013;2:3269.
Sathisha tg, manjulatha goud bk, ainash ss, jeevan shetty, orinam sarsina devi, devakiran. J Clin Diagn Res 2011;5(6):1158-60.
Steinberg D. Low density lipoprotein oxidation and its pathobiological significance. Biol Chem 1997;272:20963-8.
Sameer T Amin, MD David A Morrow, MD Eugene Braunwald, MD Sarah Sloan, MS Charles Constant. Dynamic timi risk score for stemi. J Am Heart Assoc 2013;2(1):3269.