TIMI risk score for UA/NSTEMI identifies those patients with more profound vascular insult, inflammation and thrombogenicity that, in the ‘high risk’ patient group, predicts short-term outcomes although vascular damage was the more sensitive predictor. Multivariate Cox regression analysis adjusted for clinical variables and TIMI risk score expressed as either continuous or categorical variable identified baseline CECs and ΔvWf levels (both p≤0.01) as independent predictors of subsequent cardiac events at both 14 days and 30 days. This score is a prospectively derived, validated means of estimating 1year mortality of STEMI at hospital discharge and can serve as a clinically useful tool. Fifty-eight patients with high TIMI risk score (mean 4.7) had significantly higher baseline and 48 h CEC, vWf, IL-6, TF and ΔTF levels, compared to low TIMI risk score (mean 2.4) patients (all p<0.05). The composite end point of death, myocardial infarction, and refractory angina requiring revascularisation following 14 and 30 days’ follow-up was ascertained. Patients were split into high (score ≥4) or low (<4) TIMI score groups. Thirty days risk of mortality on TIMI score was 4.97 ± 7.09, 5.01 ± 6.99, and 7.12 ± 8.64 for the patients with TIT of 120 min, 121 to 240 min. 121 to 240 min, and > 240 min, respectively. CECs, IL-6 andTF levels were measured at both time points and the acute change (Δ) calculated. Time to think beyond door to balloon time: significance of total ischemic time in STEMI Egypt Heart J. TIMI risk scores were determined at admission and 48 hours later in 88 ACS patients (60 male, age 67☑2 yrs) with UAP or NSTEMI. We hypothesised the following: (a) that a high TIMI risk score brings a greater degree of acute changes in endothelial damage/dysfunction (circulating endothelial cells, von Willebrand factor ), inflammation (interleukin-6, IL-6) and blood thrombogenicity (plasma tissue factor, TF) and (b) that these indices are higher in those with high TIMI risk score who experienced recurrent cardiac event at day 14 and day 30. Risk stratification at presentation with acute coronary syndromes (ACS) on the basis of theTIMI risk score for unstable angina and non-ST-elevation myocardial infarction (UAP/NSTEMI) identifies patients at high risk of recurrent cardiac events and those who benefit from more aggressive treatment strategy. Buy Article Permissions and Reprints Summary
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