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Atherothrombotic risk stratification after acute myocardial infarction: The Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention in the light of the French Registry of Acute ST Elevation or non-ST Elevation Myocardial Infarction registries.


ABSTRACT:

Background

Guidelines recommend using risk stratification tools in acute myocardial infarction (AMI) to assist decision-making. The Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS-2P) has been recently developed to characterize long-term risk in patients with MI.

Hypothesis

We aimed to assess the TRS-2P in the French Registry of Acute ST Elevation or non-ST elevation MI registries.

Methods

We used data from three 1-month French registries, conducted 5 years apart, from 2005 to 2015, including 13 130 patients with AMI (52% ST-elevation myocardial infarction [STEMI]). Atherothrombotic risk stratification was performed using the TRS-2P score. Patients were divided in to three categories: G1 (low-risk, TRS-2P = 0/1); G2 (intermediate-risk, TRS-2P = 2); and G3 (high-risk, TRS-2P ? 3). Baseline characteristics and outcomes were analyzed according to TRS-2P categories.

Results

A total of 12 715 patients (in whom TRS-2P was available) were included. Prevalence of G1, G2, and G3 was 43%, 24%, and 33% respectively. Clinical characteristics and management significantly differed according to TRS-2P categories. TRS-2P successfully defined residual risk of death at 1 year (C-statistic 0.78): 1-year survival was 98% in G1, 94% in G2, and 78.5% in G3 (P < 0.001). Using Cox multivariate analysis, G3 was independently associated with higher risk of death at 1 year (hazard ratio [HR] 4.61; 95% confidence interval [CI]: 3.61-5.89), as G2 (HR 2.08; 95% CI: 1.62-2.65) compared with G1. The score appeared robust and correlated well with mortality in STEMI and NSTEMI populations, as well as in each cohort separately.

Conclusions

The TRS-2P appears to be a robust risk score, identifying patients at high risk after AMI irrespective of the type of MI and historical period.

SUBMITTER: Puymirat E 

PROVIDER: S-EPMC6712320 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Atherothrombotic risk stratification after acute myocardial infarction: The Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention in the light of the French Registry of Acute ST Elevation or non-ST Elevation Myocardial Infarction registries.

Puymirat Etienne E   Bonaca Marc M   Fumery Maxime M   Tea Victoria V   Aissaoui Nadia N   Lemesles Gilles G   Bonello Laurent L   Ducrocq Grégory G   Cayla Guillaume G   Ferrières Jean J   Schiele François F   Simon Tabassome T   Danchin Nicolas N  

Clinical cardiology 20181227 2


<h4>Background</h4>Guidelines recommend using risk stratification tools in acute myocardial infarction (AMI) to assist decision-making. The Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS-2P) has been recently developed to characterize long-term risk in patients with MI.<h4>Hypothesis</h4>We aimed to assess the TRS-2P in the French Registry of Acute ST Elevation or non-ST elevation MI registries.<h4>Methods</h4>We used data from three 1-month French registries, con  ...[more]

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