Thrombolysis in myocardial infarction (TIMI) risk score remains relevant in the era of field triage of patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention

摘要

Predicting morbidity and mortality following an ST elevation myocardial infarction (STEMI) is vital for early identification of high risk patients as well as management of resources. The thrombolysis in myocardial infarction (TIMI) risk score (TRS) [1 ] is a clinical scoring tool which has been validated in multiple non-selected population cohorts, predominantly in the era of fibrinolysis [2] and non-selective cohorts of patients' undergoing primary percutaneous coronary intervention (pPQ) [3,4].The ultimate goal in STEMI management is to reduce first medical contact to TIMI grade 3 flow time [5]. Field triage attempts to reduce ischaemic time by identifying patients in the community with STEMI and transferring them directly for pPCI. Field triage reduces total ischaemic time, improves clinical outcomes and shortens hospital stay [6]. Modern day pPCI centres often work using field triage, which has been shown to reduce treatment delay and improve clinical outcome [7]. The TRS has yet to be validated in this rapidly increasing patient subgroup. While contemporary prognostic risk scores, including the GRACE score [8], are becoming more widely utilised, the TRS remains a relevant and broadly used tool owing to the speed and ease with which it is calculated [3].