14-18 One of the most widely used is the TIMI Risk Score (TRS). Numerous risk evaluation scales (scores), based on clinical characteristics and laboratory markers, have been proposed for this type of patient. 2-9 In recent years we have witnessed the setting up of chest pain units which use algorithms to generate management protocols for patients attending emergency departments with suspected acute coronary syndrome (ACS). 1,2 Results of initial studies conducted in different countries showed that a high percentage of high-risk patients were incorrectly diagnosed notably, 5%-10% of patients with an acute myocardial infarction (AMI) were discharged from emergency departments. Permite identificar a los individuos de alto riesgo que se beneficiarían de ingreso hospitalario y tratamiento agresivo precoz.Ĭhest pain is one the most frequent causes for attending clinics in Spain. El TRS es una herramienta eficaz para la estratificación pronóstica de pacientes no seleccionados que consultan por dolor torácico. El riesgo relativo de evento combinado por cada incremento del TRS fue 1,72 (IC del 95%, 1,32-2,24 p < 0,001). En el grupo de ingresados hubo 22 revascularizaciones (6,4%), 4 IAM (1,2%) y 14 muertes de causa cardiovascular (4,1%) durante el seguimiento. Los que obtuvieron una mayor puntuación en el TRS presentaron más riesgo de presentar el evento combinado muerte, infarto o revascularización (riesgo relativo por incremento de unidad = 3,63 intervalo de confianza del 95%, 2,20-6,00 p < 0,001). En el grupo dado de alta desde urgencias, 45 (5,3%) pacientes fueron ingresados durante el seguimiento, 9 (1,1%) recibieron tratamiento de revascularización, 5 (0,6%) presentaron un infarto agudo miocárdico (IAM) y 2 (0,2%) fallecieron por causa cardiovascular. Se registró la aparición de eventos cardíacos a los 6 meses. Se incluyó a 1.254 pacientes consecutivos que acudieron a urgencias por dolor torácico no traumático sin ascenso del segmento ST (edad 54 ± 19 años, 57% varones). El objetivo es comprobar la eficacia del TRS en la estratificación del riesgo en una población con dolor torácico no seleccionada.

Se ha demostrado que el TIMI Risk Score (TRS) es útil en pacientes con un riesgo intermedio y alto, pero faltan evidencias acerca de su aplicabilidad clínica en pacientes no seleccionados. Diferentes algoritmos de estratificación del síndrome coronario agudo (SCA) permiten identificar a los individuos con un mayor riesgo que pueden beneficiarse de tratamientos más agresivos. The score can identify high-risk patients who will benefit from hospital admission and early aggressive treatment. The TIMI risk score is useful for stratifying cardiovascular event risk in non-selected patients with chest pain. The relative risk of the composite endpoint per unit of TRS increase was 1.72 (95% CI, 1.32-2.24 P<.001). Of the patients who were initially admitted, 22 (6.4%) underwent revascularization, 4 (1.2%) had an MI, and 14 died (4.1%) from cardiovascular disease during follow-up. Patients with a high TRS had a significantly higher risk of reaching the composite endpoint of death, MI, or revascularization (relative risk per unit of TRS increase, 3.63 95% CI, 2.20-6.00 P<.001). Of the 911 discharged patients, 45 (5.3%) were admitted during follow-up: 9 (1.1%) underwent revascularization, 5 (0.6%) had a myocardial infarction (MI), and 2 (0.2%) died from cardiovascular disease. All cardiac events during 6-month follow-up were recorded. Overall, 343 (27%) were admitted and 911 (73%) were discharged. We evaluated 1254 consecutive patients (age, 54 years 57% male) attending an emergency department for chest pain.

Our aim was to assess the efficacy of the TRS for risk stratification in a non-selected population with chest pain. However, little is known about its value in non-selected patients. The TIMI Risk Score (TRS) has been shown to be useful in intermediate- and high-risk patients. Stratification algorithms for acute coronary syndrome enable the identification of high-risk patients who will benefit from more aggressive treatment.

A timi risk score