![]() ![]() Patients with unstable hemodynamics, evidence of ST segment elevation in the initial ECG and those who did not give consent for participating were excluded. A written informed consent was obtained from all the patients for participating in the study.Īll the patients with chest pain who were diagnosed with unstable angina or Non-ST elevation MI were entered to the study without any age or sex limitation, using census sampling. The study was approved by the ethics committee of Shahid Beheshti University of Medical Sciences and the researchers adhered to the principles of Helsinki Declaration and patient data confidentiality throughout the study. This study was designed to evaluate the diagnostic accuracy of TIMI clinical scoring system in prediction of 30-day outcome of patients presenting to ED of Imam Hossein Hospital, Tehran, Iran, with potential diagnosis of ischemic chest pain, during a 6-month period (from October 2015 to March 2016). Therefore, the present study was designed aiming to determine the diagnostic accuracy of TIMI score in predicting 30-day outcome of patients presenting to ED with diagnosis of unstable angina or Non-ST elevation MI. In this situation, using clinical scoring systems may be helpful in patient disposition. Currently, in many developing countries, supplementary diagnostic measures, such as exercise testing or echocardiography, is not available and cannot be done in EDs. in 2011 in Pennsylvania also revealed the good ability of this system in predicting the incidence of 30-day cardiovascular adverse events following typical chest pain ( 10). Additionally, in a study on 3609 ST-elevation MI patients, it was concluded that TIMI score has both short and long term value in predicting patient mortality in those that underwent primary percutaneous coronary intervention ( 9).Ī study by Lee et al. One of these systems is Thrombolysis In Myocardial Infarction (TIMI) scoring model that helps divide the patients into 2 groups of low risk (score 0-1) and high risk (score > 1) regarding adverse 30-day outcome.Ī study on 279 patients visiting ED showed that TIMI score is a valid tool for assessing 30-day mortality risk ( 8). Various clinical decision rules and scoring systems have been developed for this purpose ( 6, 7).Īn ideal model in this regard, should have high sensitivity and be able to predict the outcome accurately, using readily available clinical information. In cases that electrocardiogram (ECG), as the most available and rapid diagnostic tool, is not helpful in decision making (cases of unstable angina and Non-ST elevation MI), screening high risk patients for adverse outcomes would be very helpful. It seems that rapid diagnosis, and choosing the best treatment in the initial stages are of great importance in improving the outcome of CAD patients. It is predicted that until 2020, the number of CAD related deaths will exceed that of infectious diseases ( 5). About half of all deaths in developed countries and 25% of those in developing ones occur due to CAD ( 4). Although during the past decades, with development of preventive measures and improvement of diagnostic and therapeutic approaches, CAD related deaths have decreased by more than 40%, CAD still remains the largest killer of the US population ( 2, 3). Coronary artery disease (CAD) is a major health problem worldwide ( 1). ![]()
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