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Timi Risk Index, A Simple Tool In Emergency Percutaneous Revascularization For The Prediction Of Contrast Induced
Rajesh Kumar1, Aziz-Ur-Rehman Memon1, Abdul Hakeem Shaikh1
1National Institute of Cardiovascular Diseases, Karachi, Pakistan.
Insights
The TIMI Risk Index (TRI) effectively predicts contrast-induced nephropathy (CIN) risk in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). This validated score aids in stratifying patients at risk for CIN post-PCI.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Contrast-induced nephropathy (CIN) is a significant complication following primary percutaneous coronary intervention (PCI) in acute ST-elevation myocardial infarction (STEMI) patients.
- CIN contributes to increased morbidity and mortality in STEMI patients.
Purpose of the Study:
- To validate the TIMI Risk Index (TRI) for risk stratification of CIN in STEMI patients undergoing primary PCI.
- To assess the predictive value of TRI in identifying patients at risk for CIN.
Main Methods:
- A cohort of 507 STEMI patients undergoing primary PCI was studied.
- Patients with Killip class IV, prior PCI, or chronic kidney disease were excluded.
- TRI was calculated, and CIN was defined as a post-procedure serum creatinine increase of 25% or 0.5 mg/dL.
Main Results:
- 8.7% of patients developed CIN.
- The area under the curve (AUC) for TRI in predicting CIN was 0.717.
- TRI >22.8 showed 59.09% sensitivity and 76.69% specificity for predicting CIN.
Conclusions:
- The TIMI Risk Index is a readily accessible score with good predictive value for CIN risk in the primary PCI setting.
- TRI can be utilized for risk stratification of CIN in STEMI patients undergoing primary PCI.
Background:
Contrast induced nephropathy (CIN) is a common complication seen after primary percutaneous coronary intervention (PCI) which can contribute to increased morbidity and mortality in patients of acute ST elevation myocardial infarction (STEMI). Aim of this study was to validate the TIMI Risk Index (TRI) for the risk stratification of CIN in patients undergone primary PCI.
Methods:
Consecutive patients of STEMI undergone primary PCI at a tertiary care cardiac center were included for this study. Patients in Killip class IV at presentation, patients with history of any PCI and chronic kidney diseases were excluded from this study. TRI was calculated using the formula " " and post-procedure serum creatinine level increase of either 25% or 0.5 mg/dL was taken as CIN.
Results:
A total of 507 patients were included in this study out of which 82.2% were males and 17.8% were females. In total 8.7% (44) patients developed CIN. In the receiver operating characteristic (ROC) curve analysis, area under the curve (AUC) for TRI was found to be 0.717, [0.649-0.758] for the prediction of CIN. Sensitive, specificity, positive predictive value and negative predictive value of TRI >22.8 to predict the development of CIN were 59.09%, 76.69%, 19.55% and 95.19% respectively.
Conclusions:
TIMI risk index is and easy to calculate and readily accessible score which has good predictive value to evaluate the risk of CIN in primary PCI setting.
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