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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:
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
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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recordid: cdi_proquest_miscellaneous_67273521
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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languageeng
publisherNew York, NY: Elsevier Inc
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
3Kim, Michael C., MD
4Farkouh, Michael E., MD, MSc
5Muntner, Paul, PhD
title
0Thrombolysis In Myocardial Infarction (TIMI) Risk Score and Mortality in Patients With Advanced Chronic Kidney Disease and on Dialysis
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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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3Biological and medical sciences
4Cardiology
5Cardiology. Vascular system
6Cardiovascular
7Coronary heart disease
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9Glomerular Filtration Rate
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11Heart attacks
12Hemodialysis
13Humans
14Kidney diseases
15Kidneys
16Male
17Medical sciences
18Middle Aged
19Mortality
20Myocardial Infarction - epidemiology
21Myocardial Ischemia - epidemiology
22Myocarditis. Cardiomyopathies
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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7Coronary heart disease
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9Glomerular Filtration Rate
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26Renal Dialysis
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35Urinary system involvement in other diseases. Miscellaneous
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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