Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention of Recurrent Cardiovascular Events in a Real-World Cohort of Post-Acute Myocardial Infarction Patients
Duo Huang, Yang-Yang Cheng, Yiu-Tung Anthony Wong, See-Yue Arthur Yung, Chor-Cheung Frankie Tam, Ki-Wan Kelvin Chan, Cheung-Chi Simon Lam, Kai-Hang Yiu, Jo Jo Hai, Chu-Pak Lau, Esther W Chan, Chern-En Chiang, Ka-Lam Wong, Tommy Cheung, Bernard Man-Yung Cheung, Ying-Qing Feng, Ning Tan, Ji-Yan Chen, Wen-Sheng Yue, Hou-Xiang Hu, Ling Chen, Hung-Fat Tse, Pak-Hei Chan, Chung-Wah Siu
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Keywords: Myocardial infarction, Secondary prevention, TRS 2°P
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Supplementary material

2019 Volume 83 Issue 4 Pages 809-817

Editorial (83-4 pp. 713-714)
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Abstract

Background: Patients who survive myocardial infarction (MI) are at risk of recurrent cardiovascular (CV) events. This study stratified post-MI patients for risk of recurrent CV events using the Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P).

Methods and Results: This was an observational study that applied TRS 2°P to a consecutive cohort of post-MI patients. The primary outcome was a composite endpoint of CV death, non-fatal MI, and non-fatal ischemic stroke. A total of 1,688 post-MI patients (70.3±13.6 years; male, 63.1%) were enrolled. After a mean follow-up of 41.5±34.4 months, 405 patients (24.0%) had developed a primary outcome (9.3%/year) consisting of 278 CV deaths, 134 non-fatal MI, and 33 non-fatal strokes. TRS 2°P was strongly associated with the primary outcome. The annual incidence of primary composite endpoint for patients with TRS 2°P 0 was 1.0%, and increased progressively to 39.9% for those with TRS 2°P ≥6 (HR, 27.6; 95% CI: 9.87–77.39, P<0.001). The diagnostic sensitivity of TRS 2°P for the primary composite endpoint was 76.3% (95% CI: 72.1–80.5%). Similar associations were also observed between TRS 2°P and CV death and non-fatal MI, but not non-fatal ischemic stroke.

Conclusions: TRS 2°P reliably stratified post-MI patients for risk of future CV events.

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© 2019 THE JAPANESE CIRCULATION SOCIETY
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