Relation of TIMI risk score with plasma brain natriuretic peptide level and clinical prognosis in patients with acute coronary syndrome

AIM To evaluate the value of TIMI risk scores in estimating risk stratification in patients with acute coronary syndromes(ACS) and to determine the relationship between TIMI risk scores and plasma BNP level in ACS.METHODS The study population consisted of 123 consecutive patients with ACS who had undergone PCI(include 75 patients with STEMI and 47 patients with UAP/NSTMI).The TIMI risk score was calculated on admission and plasma BNP was measured by fluoroimmunoassay.(RESULTS) The TIMI risk scores for STEMI patients were calculated and were divided into 3 groups(TIMI scores 0 to 4,5 to 9 and 10 to 14).The higher the TIMI risk scores on admission,the worse the prognosis.The TIMI risk score was an independent predictor of in-hospital,1-month and 3-month mortality as well as in-hospital,30 day incidence of MACE(P0.01).The score could also predict 3 month(P0.01) incidence of MACE if adjusted by hypercholesterolemia(P=0.0390).The plasma BNP level of these 3 groups was significantly different(P0.01).In the multivariate model,the TIMI risk score was positively correlated with the plasma BNP level(r=0.52,P0.01),independent of other known prognostic factors(included patient age,gender,family heredity,hypercholesterolemia,diabetes,hypertension and smoking).The TIMI risk scores for UAP/NSTEMI patients were calculated and they were divided into 3 groups(TIMI scores 0 to 2,3 to 5and 6 to 7).The TIMI risk score was an independent predictor of 3-month mortality and 1-month and 3-month incidence of MACE(P0.01).The plasma BNP level of these 3 groups was significantly different(P0.01).In the multivariate model,the TIMI risk score was positively correlated with the plasma BNP level(r=0.41,P0.01).(CONCLUSION) This TIMI risk scoring system is a simple and practical tool at the bedside in quantitative risk evaluation and short-term prognosis prediction in patients with ACS.The TIMI risk score is positively correlated with the plasma BNP level.