The value of thrombolysis in myocardial infarction score in prognostic risk prediction of acute ST-segment elevation myocardial infarction

Liu Yang; Zhao Zhenjuan

doi:10.3760/cma.j.issn.1673-4777.2017.09.005

Abstract：Objective To evaluate the value of thrombolysis in myocardial infarction (TIMI) score in assessing risks of prognosis and death in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods From February 2014 to January 2016,72 patients with acute STEMI diagnosed by coronary angiography in the 2nd Affiliated Hospital of Harbin Medical University were enrolled as observation group;72 patients who were presumptively diagnosed of acute myocardial infarction but had negative results in coronary angiography were enrolled as control group.TIMI score,occurrences of in-hospital death and malignant ventricular arrhythmia were recorded.The value of TIMI score in predicting death and malignant ventricular arrhythmia was analyzed by linear correlation,logistic regression and the receiver operating characteristic (ROC) curve.Results The TIMI score in observation group was significantly higher than that in control group [(9.2 ± 2.8) points vs (5.2 ± 1.9) points] (P ＜ 0.05).The 24 h incidence of malignant ventricular arrhythmia was 8.3％ (6/72) and the in-hospital mortality rate was 5.6％ (4/72) in observation group.Linear correlation analysis showed positive correlations between TIMI score with malignant ventricular arrhythmia and in-hospital death (r =0.682,0.542;P ＜ 0.05).Logistic regression analysis showed that TIMI score was an independent predictive factor of malignant ventricular arrhythmia and in-hospital death (P ＜ 0.05).ROC curve showed that the area under curve (AUC) of TIMI score in predicting malignant ventricular arrhythmia was 0.57 (95％ confidence interval =0.49-0.65) and the optimal cut-off value was 9.49 points;the AUC of TIMI score in predicting in-hospital death was 0.74 (95％ confidence interval =0.66-0.81) and the optimal cut-off value was 11.32 points.Conclusion TIMI score is positively correlated with occurrences of malignant ventricular arrhythmia and in-hospital death in patients with STEMI.