Muhammad Khaleel Iqbal, Ijaz Ahmad, Abdul Rehman Abid, Muhammad Azhar.
Correlation of Thrombolysis in Myocardial Infarction Risk Score with the Angiographic Severity of Coronary Artery Disease in Patients with Non-ST-Elevation Acute Coronary Syndrome.
J Cardiovascular Dis Jan ;8(3):85-90.

Objective: To determine the correlation of Thrombolysis in Myocardial Infarction (TIMI) risk score with angiographic severity of coronary artery disease in patients presenting with non-ST-elevation acute coronary syndrome (NSTEACS). Subjects and Methods: This descriptive Cross sectional study was conducted at the Punjab Institute of Cardiology, Lahore from February 2007 to October 2007. A total of 100 consecutive patients of both genders and age >30 were taken at the time they presented in emergency with typical chest pain and diagnosed as NSTEACS. Informed consent was taken. Risk stratification of each patient was done by asking about presence or absence of risk indicators which were the part of TIMI risk score. Patients were classified into three categories on the basis of TIMI risk score: patients at low risk (risk score 0-2), patients at intermediate risk (risk score 3-4), and those at high risk (risk score 5-7). Angiography of each patient was then performed and severity of CAD (one-vessel or two-vessel or three-vessel disease) was known from the angiographic findings which were recorded in a proforma. Results: In our study, the severity of coronary artery disease on angiography was directly related to TIMI risk score. More patients of 1-vessel disease (54.5%) were from low risk category as compared to 45.5% patients from intermediate risk category. No patient of one-vessel CAD was from high risk category. Similarly, Two-vessel CAD was more common in intermediate risk category (50%) as compared to low risk category (41.2%) and high risk category (8.8%). Three-vessel CAD was also most common in intermediate risk category (63.9%) where it was commoner than that in low risk group(33%). Mean TIMI risk score increased with increasing severity of CAD. It was 1.5±0.5, 2.4± 0.9, 2.7±1.2, and 2.8±1.1 for non-significant, one-vessel, two-vessel and three-vessel CAD respectively. Using the test of significance, correlation coefficient (r) between TIMI risk score and number of diseased vessels turned out to be 0.274 and p value was <0.01. Conclusion: In patients with non-ST-elevation acute coronary syndrome, the TIMI risk score is correlated with severity of coronary artery disease on angiography. With each increase in TIMI risk score category the severity of coronary artery disease also increases and there are increased chances of finding severe disease on angiography. Key Words: TIMI risk score; Coronary artery disease; Non ST Elevation ACS; atherosclerosis; Coronary angiography.

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