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Updated: Sep 20, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

TIMI Risk Score for Secondary Prevention to Risk Stratify Chronic Coronary Syndrome Patients: External Validation

Henrique Trombini Pinesi^1,2, Eduardo Martelli Moreira¹, Marcelo Henrique Moreira Barbosa¹

¹Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.

Arquivos Brasileiros De Cardiologia

|May 28, 2025

Summary

This summary is machine-generated.

The TIMI Risk Score for Secondary Prevention (TRS2P) identifies high-risk chronic coronary syndrome patients but underestimates cardiovascular events and shows poor discrimination in Brazil. Further validation is needed for this population.

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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

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Published on: March 15, 2022

Area of Science:

Cardiology
Clinical Risk Stratification
Public Health

Background:

Chronic coronary syndrome (CCS) patient risk stratification is complex.
The TIMI Risk Score for Secondary Prevention (TRS2P) predicts major adverse cardiovascular events (MACE) in post-myocardial infarction (MI) patients.
No prior studies validated TRS2P in the Brazilian CCS population.

Purpose of the Study:

To validate the predictive accuracy of the TRS2P score in a Brazilian cohort of CCS patients.
To assess the calibration and discrimination of the TRS2P score in this specific population.

Main Methods:

A registry-based study included 515 CCS patients.
The primary outcome was the three-year incidence of MACE (death, MI, or stroke).
Calibration was assessed using a calibration plot and Hosmer-Lemeshow test; discrimination was evaluated with the C-statistic.

Main Results:

The observed three-year MACE incidence was 24%, significantly higher than the predicted 15%.
The TRS2P score underestimated MACE incidence across all risk strata (p < 0.01).
The model demonstrated poor discrimination, with a C-statistic of 0.64.

Conclusions:

The TRS2P score identifies higher-risk CCS patients but underestimates MACE in a Brazilian cohort.
The score exhibits poor discrimination and requires recalibration for use in this population.
This study highlights the need for population-specific risk models in cardiovascular medicine.