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Thrombolysis In Myocardial Infarction (TIMI) Risk Score and Mortality in Patients With Advanced Chronic Kidney Disease and on Dialysis

There are limited data on the validity of the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina pectoris (UAP)/non–ST-elevation myocardial infarction in patients with moderate to advanced chronic kidney disease (CKD), including patients using dialysis. Accordingly, we evalu... Full description

Journal Title: The American journal of cardiology 2009, Vol.103 (11), p.1513-1517
Main Author: Baber, Usman, MD
Other Authors: Kini, Annapoorna S., MD , Sharma, Samin K., MD , Kim, Michael C., MD , Farkouh, Michael E., MD, MSc , Muntner, Paul, PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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title: Thrombolysis In Myocardial Infarction (TIMI) Risk Score and Mortality in Patients With Advanced Chronic Kidney Disease and on Dialysis
format: Article
creator:
  • Baber, Usman, MD
  • Kini, Annapoorna S., MD
  • Sharma, Samin K., MD
  • Kim, Michael C., MD
  • Farkouh, Michael E., MD, MSc
  • Muntner, Paul, PhD
subjects:
  • Abridged Index Medicus
  • Aged
  • Angina pectoris
  • Biological and medical sciences
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Coronary heart disease
  • Female
  • Glomerular Filtration Rate
  • Heart
  • Heart attacks
  • Hemodialysis
  • Humans
  • Kidney diseases
  • Kidneys
  • Male
  • Medical sciences
  • Middle Aged
  • Mortality
  • Myocardial Infarction - epidemiology
  • Myocardial Ischemia - epidemiology
  • Myocarditis. Cardiomyopathies
  • Nephrology. Urinary tract diseases
  • Nephropathies. Renovascular diseases. Renal failure
  • Prognosis
  • Renal Dialysis
  • Renal failure
  • Renal Insufficiency, Chronic - mortality
  • Renal Insufficiency, Chronic - physiopathology
  • Renal Insufficiency, Chronic - therapy
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Thrombosis
  • Urinary system involvement in other diseases. Miscellaneous
ispartof: The American journal of cardiology, 2009, Vol.103 (11), p.1513-1517
description: There are limited data on the validity of the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina pectoris (UAP)/non–ST-elevation myocardial infarction in patients with moderate to advanced chronic kidney disease (CKD), including patients using dialysis. Accordingly, we evaluated the prognostic ability of the TIMI risk score in consecutive patients across the entire spectrum of CKD who presented with UAP or non–ST elevation myocardial infarction and underwent percutaneous coronary intervention from July 1, 1999, to June 30, 2007. Patients were categorized by estimated glomerular filtration rate (eGFR) ≥60 (n = 4,938), 30 to 59 (n = 1,592), and
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleThrombolysis In Myocardial Infarction (TIMI) Risk Score and Mortality in Patients With Advanced Chronic Kidney Disease and on Dialysis
creatorBaber, Usman, MD ; Kini, Annapoorna S., MD ; Sharma, Samin K., MD ; Kim, Michael C., MD ; Farkouh, Michael E., MD, MSc ; Muntner, Paul, PhD
creatorcontribBaber, Usman, MD ; Kini, Annapoorna S., MD ; Sharma, Samin K., MD ; Kim, Michael C., MD ; Farkouh, Michael E., MD, MSc ; Muntner, Paul, PhD
descriptionThere are limited data on the validity of the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina pectoris (UAP)/non–ST-elevation myocardial infarction in patients with moderate to advanced chronic kidney disease (CKD), including patients using dialysis. Accordingly, we evaluated the prognostic ability of the TIMI risk score in consecutive patients across the entire spectrum of CKD who presented with UAP or non–ST elevation myocardial infarction and underwent percutaneous coronary intervention from July 1, 1999, to June 30, 2007. Patients were categorized by estimated glomerular filtration rate (eGFR) ≥60 (n = 4,938), 30 to 59 (n = 1,592), and <30 ml/min/1.73 m2 (n = 202) and use of dialysis (n = 208). Hazard ratios of all-cause mortality associated with TIMI risk score levels (0 to 2, 3 to 4, ≥5) were calculated within each eGFR category. Over a median follow-up of 3.2 years, 813 deaths occurred. For patients with an eGFR ≥60 ml/min/1.73 m2 , race- and gender-adjusted hazard ratios of mortality associated with TIMI risk scores of 3 to 4 and ≥5 compared with 0 to 2 were 2.92 (95% confidence interval [CI] 1.93 to 4.40) and 4.26 (95% CI 2.82 to 6.43), respectively. Analogous hazard ratios were 1.26 (95% CI 0.80 to 1.98) and 1.77 (95% CI 1.13 to 2.78) for patients with an eGFR of 30 to 59 ml/min/1.73 m2 , 2.23 (95% CI 0.71 to 6.94) and 2.83 (95% CI 0.89 to 8.99) for patients with an eGFR <30 ml/min/1.73 m2 , and 3.16 (1.33 to 7.48) and 3.67 (95% CI 1.52 to 8.86), respectively, for patients on dialysis. In conclusion, the TIMI risk score for UAP/non–ST elevation myocardial infarction discriminates mortality risk across the full range of CKD, including patients on dialysis.
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subjectAbridged Index Medicus ; Aged ; Angina pectoris ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Coronary heart disease ; Female ; Glomerular Filtration Rate ; Heart ; Heart attacks ; Hemodialysis ; Humans ; Kidney diseases ; Kidneys ; Male ; Medical sciences ; Middle Aged ; Mortality ; Myocardial Infarction - epidemiology ; Myocardial Ischemia - epidemiology ; Myocarditis. Cardiomyopathies ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Prognosis ; Renal Dialysis ; Renal failure ; Renal Insufficiency, Chronic - mortality ; Renal Insufficiency, Chronic - physiopathology ; Renal Insufficiency, Chronic - therapy ; Risk Assessment ; Risk Factors ; Survival Analysis ; Thrombosis ; Urinary system involvement in other diseases. Miscellaneous
ispartofThe American journal of cardiology, 2009, Vol.103 (11), p.1513-1517
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1Kini, Annapoorna S., MD
2Sharma, Samin K., MD
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4Farkouh, Michael E., MD, MSc
5Muntner, Paul, PhD
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descriptionThere are limited data on the validity of the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina pectoris (UAP)/non–ST-elevation myocardial infarction in patients with moderate to advanced chronic kidney disease (CKD), including patients using dialysis. Accordingly, we evaluated the prognostic ability of the TIMI risk score in consecutive patients across the entire spectrum of CKD who presented with UAP or non–ST elevation myocardial infarction and underwent percutaneous coronary intervention from July 1, 1999, to June 30, 2007. Patients were categorized by estimated glomerular filtration rate (eGFR) ≥60 (n = 4,938), 30 to 59 (n = 1,592), and <30 ml/min/1.73 m2 (n = 202) and use of dialysis (n = 208). Hazard ratios of all-cause mortality associated with TIMI risk score levels (0 to 2, 3 to 4, ≥5) were calculated within each eGFR category. Over a median follow-up of 3.2 years, 813 deaths occurred. For patients with an eGFR ≥60 ml/min/1.73 m2 , race- and gender-adjusted hazard ratios of mortality associated with TIMI risk scores of 3 to 4 and ≥5 compared with 0 to 2 were 2.92 (95% confidence interval [CI] 1.93 to 4.40) and 4.26 (95% CI 2.82 to 6.43), respectively. Analogous hazard ratios were 1.26 (95% CI 0.80 to 1.98) and 1.77 (95% CI 1.13 to 2.78) for patients with an eGFR of 30 to 59 ml/min/1.73 m2 , 2.23 (95% CI 0.71 to 6.94) and 2.83 (95% CI 0.89 to 8.99) for patients with an eGFR <30 ml/min/1.73 m2 , and 3.16 (1.33 to 7.48) and 3.67 (95% CI 1.52 to 8.86), respectively, for patients on dialysis. In conclusion, the TIMI risk score for UAP/non–ST elevation myocardial infarction discriminates mortality risk across the full range of CKD, including patients on dialysis.
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5Cardiology. Vascular system
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9Glomerular Filtration Rate
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14Kidney diseases
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21Myocardial Ischemia - epidemiology
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23Nephrology. Urinary tract diseases
24Nephropathies. Renovascular diseases. Renal failure
25Prognosis
26Renal Dialysis
27Renal failure
28Renal Insufficiency, Chronic - mortality
29Renal Insufficiency, Chronic - physiopathology
30Renal Insufficiency, Chronic - therapy
31Risk Assessment
32Risk Factors
33Survival Analysis
34Thrombosis
35Urinary system involvement in other diseases. Miscellaneous
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titleThrombolysis In Myocardial Infarction (TIMI) Risk Score and Mortality in Patients With Advanced Chronic Kidney Disease and on Dialysis
authorBaber, Usman, MD ; Kini, Annapoorna S., MD ; Sharma, Samin K., MD ; Kim, Michael C., MD ; Farkouh, Michael E., MD, MSc ; Muntner, Paul, PhD
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abstractThere are limited data on the validity of the Thrombolysis In Myocardial Infarction (TIMI) risk score for unstable angina pectoris (UAP)/non–ST-elevation myocardial infarction in patients with moderate to advanced chronic kidney disease (CKD), including patients using dialysis. Accordingly, we evaluated the prognostic ability of the TIMI risk score in consecutive patients across the entire spectrum of CKD who presented with UAP or non–ST elevation myocardial infarction and underwent percutaneous coronary intervention from July 1, 1999, to June 30, 2007. Patients were categorized by estimated glomerular filtration rate (eGFR) ≥60 (n = 4,938), 30 to 59 (n = 1,592), and <30 ml/min/1.73 m2 (n = 202) and use of dialysis (n = 208). Hazard ratios of all-cause mortality associated with TIMI risk score levels (0 to 2, 3 to 4, ≥5) were calculated within each eGFR category. Over a median follow-up of 3.2 years, 813 deaths occurred. For patients with an eGFR ≥60 ml/min/1.73 m2 , race- and gender-adjusted hazard ratios of mortality associated with TIMI risk scores of 3 to 4 and ≥5 compared with 0 to 2 were 2.92 (95% confidence interval [CI] 1.93 to 4.40) and 4.26 (95% CI 2.82 to 6.43), respectively. Analogous hazard ratios were 1.26 (95% CI 0.80 to 1.98) and 1.77 (95% CI 1.13 to 2.78) for patients with an eGFR of 30 to 59 ml/min/1.73 m2 , 2.23 (95% CI 0.71 to 6.94) and 2.83 (95% CI 0.89 to 8.99) for patients with an eGFR <30 ml/min/1.73 m2 , and 3.16 (1.33 to 7.48) and 3.67 (95% CI 1.52 to 8.86), respectively, for patients on dialysis. In conclusion, the TIMI risk score for UAP/non–ST elevation myocardial infarction discriminates mortality risk across the full range of CKD, including patients on dialysis.
copNew York, NY
pubElsevier Inc
pmid19463508
doi10.1016/j.amjcard.2009.01.364