Use of Thrombolysis in Myocardial Infarction Risk Score to predict bleeding complications in patients with unstable angi
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ORIGINAL ARTICLE
Use of Thrombolysis in Myocardial Infarction Risk Score to predict bleeding complications in patients with unstable angina and non-ST elevation myocardial infarction undergoing percutaneous coronary intervention Yohei Numasawa • Shun Kohsaka • Hiroaki Miyata • Akio Kawamura • Shigetaka Noma • Masahiro Suzuki • Susumu Nakagawa • Yukihiko Momiyama Toshiyuki Takahashi • Yuji Sato • Keiichi Fukuda
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Received: 8 July 2012 / Accepted: 12 January 2013 / Published online: 30 January 2013 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2013
Abstract Thrombolysis in myocardial infarction (TIMI) is a prognostic score developed for managing the high risk of cardiac events immediately after unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI). In Asian populations that have a higher rate of bleeding complications, data about TIMI score are lacking. Using a Japanese multicenter registry, we investigated the impact of utilizing TIMI score in UA/NSTEMI patients, focusing on bleeding complications. The TIMI score was calculated for 587 patients who underwent percutaneous coronary intervention (PCI) for UA/NSTEMI (2008–2010). They were classified into low-risk (TIMI score 0–2, N = 268, 45.6 %), intermediate-risk (TIMI score 3–4, N = 264, 45.0 %) and high-risk (TIMI score 5–7, N = 55, 9.4 %) groups; patient characteristics for each group were statistically analyzed. The patients in the higher TIMI score group were older (p \ 0.001), had lower GFR (p = 0.021) and hemoglobin level after PCI (p \ 0.001), and severe coronary disease pattern (p = 0.014 and p = 0.023, respectively, for left main and three-vessel disease). The
Y. Numasawa (&) T. Takahashi Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga-shi, Tochigi, Japan e-mail: [email protected] S. Kohsaka A. Kawamura K. Fukuda Department of Cardiology, Keio University School of Medicine, Tokyo, Japan H. Miyata University of Tokyo, Healthcare Quality Assessment, Tokyo, Japan S. Noma Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan
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TIMI score was significantly associated with requirement of blood transfusion (low-risk, moderate-risk, and high-risk groups: 1.1, 4.2, and 7.3 %, respectively; p = 0.021), and the incidence of access site bleeding (1.1, 2.7, and 5.5 %, p = 0.112). The TIMI score might aid in subjectively quantifying the risk of in-hospital complication rates such as access site bleeding. Keywords TIMI score Percutaneous coronary intervention Coronary artery disease
Introduction Despite the increased use of coronary revascularization, patients with unstable angina (UA)/non-ST elevation myocardial infarction (NSTEMI) remain at risk for subsequent cardiac and arrhythmic events. Therefore, accurate risk stratification is important in patients with complaints suggestive of UA/NSTEMI [1, 2]. Thrombolysis in myocardial infarction (TIMI) score is derived from 7 variables M. Suzuki Department of Cardiology, National Hospital Organization, Saita
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