Prediction of In-Hospital Mortality in ST-Segment Elevation Myocardial Infarction: What is the Role of Thrombolysis in Myocardial Infarction Risk Index?

Abstract

Introduction: Thrombolysis in myocardial infarction (TIMI) risk index has been developed to predict the prognosis in pa- tients with coronary artery disease. In this study, we evaluated the prognostic value of TIMI risk index in patients with ST-seg- ment elevation myocardial infarction (STEMI) when TIMI risk index was calculated in the emergency department (ED) and patients were referred to an interventional center. Methods: In this retrospective analysis, we evaluated the in-hospital mortality prognostic impact of TIMI risk index on 944 patients with STEMI treated with primary percutaneous coronary intervention. Patients were divided into two groups ac- cording to the presence of in-hospital mortality and the baseline features were compared between these groups. Multivar- iate analysis was implemented to detect independent predictors of in-hospital mortality. Results: TIMI risk index was an independent predictor (OR: 5.75; 95% confidence interval: 2.09–15.8; p=0.0007) of in-hospital mortality besides Killip stage, chronic kidney disease, and total ischemic time according to the results of the multivariate regression analysis. ROC analysis showed that the best cutoff value of the TIMI risk index to predict in-hospital mortality was 29.3 with 79.1% sensitivity and 80.7% specificity. Discussion and Conclusion: Our study indicated that TIMI risk index calculated in the ED is an independent prognostic factor for in-hospital mortality in patients with STEMI.