Abstract :
Background and Aims: Western studies have shown that TIMI (Thrombolysis In MyocardialInfarction) risk scores predict adverse events in patients with non ST-elevation acute coronary syndrome(NSTEACS) and ST-elevation myocardial infarction (STEMI). Whether this also applies to Jordanianpatients is largely unknown. Materials and Methods: We prospectively followed up 656 patients with ACS for total mortality,combined events of death, nonfatal MI or urgent coronary revascularization up to one year afteradmission. Results: Of the whole group, 472 patients (72%) had NSTEACS, and 184 patients (28%) had STEMI.Among NSTEACS patients, 31.0% had a low risk score (total points 0 - 2 of 7), 43.5% had anintermediate risk score (total points 3 - 4), and 25.5% had a high risk score (total points 5 - 7). In-hospital mortality was not different in the respective risk score groups (1.4%, 0.5%, and 3.4%, p =0.123). At 1 year, mortality was significantly higher in the high risk score group (12.8%) compared withthe intermediate (4%) and low (1.4%) risk groups (p = 0.001). Among STEMI patients, 58.6% had a lowrisk score (total points 0 - 3 of 13 - 14), 31.0% had a low intermediate risk score (total points 4 - 6),8.0% had a high intermediate score (total points 7 - 9), and 2.4% had a high risk score (total points 10). In-hospital mortality rate was significantly higher in the two intermediate risk score groups (7.4%,14.3%, respectively) and the high risk score group (50%) compared with the low risk score group (1.0%,p = 0.001). The high risk and the two intermediate risk groups also had higher one-year mortality (75%,28.6% and 16.7%, respectively) than the low risk group (3.9%, p = 0.001). Similarly, composite eventsoccurred at a significantly higher rate in patients with high risk scores than intermediate or low riskscores among NSTEACS and STEMI patients. Conclusions: In Jordanian ACS patients, high TIMI risk scores were associated with a high risk ofcardiovascular events. Such patients are candidates for early aggressive therapeutic strategies.
