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Use of Thrombolysis in Myocardial Infarction Risk Score to predict bleeding complications in patients with unstable angina and non-ST elevation myocardial infarction undergoing percutaneous coronary intervention

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Abstract

Thrombolysis in myocardial infarction (TIMI) is a prognostic score developed for managing the high risk of cardiac events immediately after unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI). In Asian populations that have a higher rate of bleeding complications, data about TIMI score are lacking. Using a Japanese multicenter registry, we investigated the impact of utilizing TIMI score in UA/NSTEMI patients, focusing on bleeding complications. The TIMI score was calculated for 587 patients who underwent percutaneous coronary intervention (PCI) for UA/NSTEMI (2008–2010). They were classified into low-risk (TIMI score 0–2, N = 268, 45.6 %), intermediate-risk (TIMI score 3–4, N = 264, 45.0 %) and high-risk (TIMI score 5–7, N = 55, 9.4 %) groups; patient characteristics for each group were statistically analyzed. The patients in the higher TIMI score group were older (p < 0.001), had lower GFR (p = 0.021) and hemoglobin level after PCI (p < 0.001), and severe coronary disease pattern (p = 0.014 and p = 0.023, respectively, for left main and three-vessel disease). The TIMI score was significantly associated with requirement of blood transfusion (low-risk, moderate-risk, and high-risk groups: 1.1, 4.2, and 7.3 %, respectively; p = 0.021), and the incidence of access site bleeding (1.1, 2.7, and 5.5 %, p = 0.112). The TIMI score might aid in subjectively quantifying the risk of in-hospital complication rates such as access site bleeding.

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Acknowledgments

We appreciate all the investigators, clinical coordinators and institutions involved in the JCD-KICS study. This research was supported by a grant from the Ministry of Education, Culture, Sports, Science, and Technology, Japan (KAKENHI No. 21790751). Investigators Sonhan Yun, and Toshiyuki Takahashi (Ashikaga Red Cross Hospital); Yutaka Okada and Takashi Koyama (Eiju General Hospital); Soushin Inoue (Hino Municipal Hospital); Kimi Koide and Masaru Shibata (Hiratsuka City Hospital); Shunsuke Takagi (Isehara Kyodo Hospital); Keishu Li and Koichiro Sueyoshi (Kawasaki City Municipal Hospital); Masashi Takahashi, Yohei Ohno, Takahide Arai, Shinsuke Yuasa, Yuichiro Maekawa and Akio Kawamura (Keio University School of Medicine); Masahiro Suzuki (National Hospital Organization Saitama National Hospital); Yukinori Ikegami and Yukihiko Momiyama (National Hospital Organization Tokyo Medical Center); Ayaka Endo, Toshiyuki Takahashi and Susumu Nakagawa (Saiseikai Central Hospital); Takashi Yagi, Takeshi Onitsuka and Shigetaka Noma (Saiseikai Utsunomiya Hospital); Shiro Ishikawa (Saitama City Hospital); Atsushi Mizuno, Shuzo Nishihara, Hitoshi Anzai and Yutaro Nishi (St Luke’s International Hospital Heart Center); Takahiro Oki (Tokyo Dental College Ichikawa General Hospital). Clinical coordinators Fumika Tamura, Junko Susa, Hiroe Fukuda, Ayano Ishikawa, Shuko Oonuki and Ikuko Ueda.

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Authors and Affiliations

  1. Department of Cardiology, Ashikaga Red Cross Hospital, 284-1 Yobe-cho, Ashikaga-shi, Tochigi, Japan

    Yohei Numasawa & Toshiyuki Takahashi

  2. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan

    Shun Kohsaka, Akio Kawamura & Keiichi Fukuda

  3. University of Tokyo, Healthcare Quality Assessment, Tokyo, Japan

    Hiroaki Miyata

  4. Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan

    Shigetaka Noma

  5. Department of Cardiology, National Hospital Organization, Saitama National Hospital, Saitama, Japan

    Masahiro Suzuki

  6. Department of Cardiology, Saiseikai Central Hospital, Tokyo, Japan

    Susumu Nakagawa

  7. Department of Cardiology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan

    Yukihiko Momiyama

  8. Center for Clinical Research, Keio University School of Medicine, Tokyo, Japan

    Yuji Sato

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  1. Yohei Numasawa
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  2. Shun Kohsaka
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Correspondence to Yohei Numasawa.

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Numasawa, Y., Kohsaka, S., Miyata, H. et al. Use of Thrombolysis in Myocardial Infarction Risk Score to predict bleeding complications in patients with unstable angina and non-ST elevation myocardial infarction undergoing percutaneous coronary intervention. Cardiovasc Interv and Ther 28, 242–249 (2013). https://doi.org/10.1007/s12928-013-0162-3

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