American Heart Journal
Volume 149, Issue 5 , Pages 846-850 , May 2005

Correlation between the TIMI risk score and high-risk angiographic findings in non–ST-elevation acute coronary syndromes: Observations from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) trial

  • Jessica L. Mega, MD

      Affiliations

    • TIMI Study Group
    • ,
  • David A. Morrow, MD, MPH

      Affiliations

    • TIMI Study Group
    • Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass
    • Corresponding Author InformationReprint requests. David A. Morrow, MD, MPH, TIMI Study Group, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115.
    • ,
  • Marc S. Sabatine, MD, MPH

      Affiliations

    • TIMI Study Group
    • Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Xue-Qiao Zhao, MD

      Affiliations

    • Department of Medicine, University of Washington School of Medicine, Seattle, Wash
    • ,
  • Steven M. Snapinn, PhD

      Affiliations

    • Merck & Co., West Point, Pa
    • ,
  • Peter M. DiBattiste, MD

      Affiliations

    • Merck & Co., West Point, Pa
    • ,
  • C. Michael Gibson, MS, MD

      Affiliations

    • TIMI Study Group
    • ,
  • Elliott M. Antman, MD

      Affiliations

    • TIMI Study Group
    • Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Eugene Braunwald, MD

      Affiliations

    • TIMI Study Group
    • Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass
    • ,
  • Pierre Théroux, MD

      Affiliations

    • Montreal Heart Institute, Quebec, Canada

Received 30 January 2004 ,Accepted 11 August 2004.

References 

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  2. Antman EM, McCabe CH, Gurfinkel EP, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non–Q-wave myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI) 11B trial. Circulation. 1999;100:1593–1601
  3. Cannon CP, Weintraub WS, Demopoulos LA, et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban. N. Engl. J. Med. 2001;344:1879–1887
  4. Morrow DA, Antman EM, Snapinn SM, et al. An integrated clinical approach to predicting the benefit of tirofiban in non-ST elevation acute coronary syndromes. Application of the TIMI risk score for UA/NSTEMI in PRISM-PLUS. Eur. Heart J. 2002;23:223–229
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  7. Morrow DA. New insight into clinical risk scores for patients with acute coronary syndromes. Am. Heart J. 2003;146:754–756
  8. The PRISM-PLUS Investigators . Inhibition of the platelet glycoprotein IIb/IIIa receptor with tirofiban in unstable angina and non–Q-wave myocardial infarction. N. Engl. J. Med. 1998;338:1488–1497
  9. Zhao XQ, Theroux P, Snapinn SM, et al. Intracoronary thrombus and platelet glycoprotein IIb/IIIa receptor blockade with tirofiban in unstable angina or non–Q-wave myocardial infarction. Angiographic results from the PRISM-PLUS trial (platelet receptor inhibition for ischemic syndrome management in patients limited by unstable signs and symptoms). PRISM-PLUS Investigators. Circulation. 1999;100:1609–1615
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  13. Cohen M, Hawkins L, Greenberg S, et al. Usefulness of ST-segment changes in greater than or equal to 2 leads on the emergency room electrocardiogram in either unstable angina pectoris or non–Q-wave myocardial infarction in predicting outcome. Am. J. Cardiol. 1991;67:1368–1373
  14. Miranda CP, Lehmann KG, Froelicher VF. Correlation between resting ST segment depression, exercise testing, coronary angiography, and long-term prognosis. Am. Heart J. 1991;122:1617–1628
  15. Heeschen C, van Den Brand MJ, Hamm CW, et al. Angiographic findings in patients with refractory unstable angina according to troponin T status. Circulation. 1999;100:1509–1514
  16. Benamer H, Steg PG, Benessiano J, et al. Elevated cardiac troponin I predicts a high-risk angiographic anatomy of the culprit lesion in unstable angina. Am. Heart J. 1999;137:815–820
  17. Dangas G, Mehran R, Wallenstein S, et al. Correlation of angiographic morphology and clinical presentation in unstable angina. J. Am. Coll. Cardiol. 1997;29:519–525
  18. Santopinto J, Gurfinkel EP, Torres V, et al. Prior aspirin users with acute non–ST-elevation coronary syndromes are at increased risk of cardiac events and benefit from enoxaparin. Am. Heart J. 2001;141:566–572
  19. Alexander JH, Harrington RA, Tuttle RH, et al. Prior aspirin use predicts worse outcomes in patients with non–ST-elevation acute coronary syndromes. PURSUIT Investigators. Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy. Am. J. Cardiol. 1999;83:1147–1451
  20. Cannon CP. Evidence-based risk stratification to target therapies in acute coronary syndromes. Circulation. 2002;106:1588–1591

 The PRISM-PLUS trial was supported by Merck & Co, Inc.

PII: S0002-8703(04)00765-3

doi: 10.1016/j.ahj.2004.08.042

American Heart Journal
Volume 149, Issue 5 , Pages 846-850 , May 2005

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