ASSOCIATION BETWEEN SEVERITY OF CLINICAL PRESENTATION AND EXTENT OF CORONARY ARTERY DISEASE IN PATIENTS WITH ST ELEVATION MYOCARDIAL INFRACTION

Abstract

Background: Acute myocardial infarction (AMI) with ST elevation (STEMI) continues to be a major cause of morbidity and mortality throughout the world. The Thrombolysis in Myocardial Infarction (TIMI) risk score is a simple clinical tool and the Gensini score is an angiographic scoring system that gives an assessment of the severity of CAD.

Objective: To assess the relationship between TIMI risk score and Gensini score in patients admitted with STEMI.

Methods: This cross-sectional descriptive study was performed during a six months period in the department of Cardiology, National Institute of Cardiovascular Diseases (NICVD) Karachi. The patients who had STEMI were selected by consecutive non-probability sampling and there were 333 patients in the age group of 18-70 years. Demographic and clinical data were collected. TIMI risk scores were computed and classified as low (0–2), intermediate (3–7) and high (≥8). The SPSS version 21 software was used for data analysis.

Results: The mean age was 57.4 ± 9.8 years with 76.0% male. Of these, 61.3% of patients had hypertension, 36.9% had diabetes mellitus and 39.9% smoked. Based on TIMI risk stratification, 24.0% were low risk, 57.7% intermediate risk, and 18.3% high risk. There was a strong correlation between TIMI risk categories and groups of Gensini score (p<0.001). There was a moderate positive correlation between the TIMI and Gensini scores (r=0.56, p<0.001) as confirmed by Pearson's analysis (r=0.53, p<0.001).

Conclusion: There was significant positive correlation between TIMI risk score and Gensini score in STEMI patients.