Correlation of thrombolysis in myocardial infarction (TIMI) risk score with extent of coronary artery disease in patients with acute coronary syndrome.

Objective: To determine the correlation of thrombolysis in myocardial infarction (TIMI) risk score with extent of coronary artery disease (CAD) in patients with acute coronary syndrome (ACS).

Methods: We conducted a descriptive study among 200 consecutive patients admitted with ACS at Tabba Heart Institute, Karachi from June to December 2008. The TIMI risk score was stratified on seven standard variables. The extent of CAD was evaluated on angiography and significant CAD was defined as > or =70% stenosis in any one of the three major epicardial vessels.

Results: The mean age of the sample was 58.53 +/- 10.64 years. Out of 200 patients, there were 142 (71%) patients with TIMI score < or =4 (low and intermediate TIMI risk score) and 58 (29%) patients with TIMI score >4 (high TIMI risk score). Patients with TIMI score >4 were more likely to have significant three vessel CAD (62%) versus those with TIMI risk score <4 (46.2%), (p < 0.04).

Conclusion: Patients with high TIMI risk score were more likely to have severe multivessel CAD compared with those with low or intermediate TIMI risk score. Hence, patients with TIMI score >4 should be referred for early invasive coronary evaluation to derive clinical benefit.