Outcomes of Primary Percutaneous Coronary Intervention in Patients With a Thrombolysis in Myocardial Infarction Score of Five or Higher

Abstract

Background Primary percutaneous coronary intervention (PCI) is a treatment of choice for patients with STsegment elevation myocardial infarction (STEMI). Of the various risk stratification scores that have been introduced, the thrombolysis in myocardial infarction (TIMI) score is among the most used modalities. Patients with a TIMI score of five or higher are classified as high-risk patients with higher rates of adverse events. Therefore, this study aimed to determine the rate of adverse events after primary PCI in patients presenting with STEMI and a TIMI score of five or higher. Methodology This descriptive study was conducted at the cardiology department of the Liaquat National Hospital, Karachi, from February 2018 to August 2018. The patients included in this study consisted of a total of 150 men and women who presented to the ED with concerns of chest pain and were diagnosed with STEMI and had a TIMI score of five or higher. Consultant cardiologists performed primary PCI procedures, and any post-procedure adverse events were recorded during the patients' hospital stays (up to one week), including mortality, heart failure, cardiogenic shock, and ventricular arrhythmias. Results The study population was 83.3% male and 16.7% female patients, and the mean age was 54.0 ± 9.4 years. The mean BMI was 27.34 ± 2.76 kg/m 2. The mean TIMI score was 9.19 ± 2.71, with a TIMI score higher than eight for 52.7% of patients. Death was observed in 18.7% of cases, heart failure in 21.3% of cases, cardiogenic shock in 13.3% of cases, and ventricular arrhythmia in 22.0% of cases. Conclusion A TIMI risk score of five or higher can identify patients at high risk not only for mortality, but also for heart failure, cardiogenic shock, and ventricular arrhythmias.

Angiographic characteristics of culprit lesions in infarct related artery and correlation of TIMI score with SYNTAX score to predict extent and severity of coronary artery disease in patients undergoing primary percutaneous coronary interventions

“…Similarly, in a study by Talreja et al, including 150 patients, 52.7% of the cases were classified as high risk, and 47.3% were at moderate risk. 16 In a study by Iltaf and colleagues, 31.84% of the patients receiving primary PCI had a TIMI risk score of ≥ 9. 17 The study also found that patients with a TIMI score of nine had higher rates of adverse events and complications, including death, stroke, and pulmonary edema, compared to the outcomes of primary PCI that had previously been reported in sizable registry-based studies.…”

Factors Associated with Increased Length of Stay in Post Primary Percutaneous Coronary Intervention Patients: A Scoping Review

“…Thus, assessing the risk stratification of each patient, especially after undergoing PPCI is very important. 55 The commonly used tool to assess the success of PCI is the TIMI grade flow. 55 However, the results of this review indicate that only a few studies have reported the results of TIMI of flow post-PPCI.…”

“…55 The commonly used tool to assess the success of PCI is the TIMI grade flow. 55 However, the results of this review indicate that only a few studies have reported the results of TIMI of flow post-PPCI. 13,19,22,23,33 In fact, evaluating the TIMI score after PCI indicates the success of the action, which is closely related to the prognosis and severity of the patient, so it influences LOS.…”

Quality of Life Result after Underwent Percutaneous Coronary Intervention (PCI): LIterature Review

“…The indication of PCI in CAD patient is based on the clinical condition and it is highly recommended in the condition that CAD affect quality of life (Abubakar et al, 2023). Primary PCI is a treatment that given to STEMI patients within 12 hours since the symptoms occur (Talreja et al, 2020). Also, in unstable angina patient, time become very important to conduct PCI in order to prevent MI in the patient.…”