![]() Liraglutide and cardiovascular outcomes in type 2 diabetes. LEADER Steering Committee LEADER Trial Investigators. Marso SP, Daniels GH, Brown-Frandsen K, et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. IDF Diabetes Atlas: global estimates of the prevalence of diabetes for 20. 2 or more risk factors for coronary artery disease, known coronary artery stenosis, ST-segment deviation on present- ing. Whiting DR, Guariguata L, Weil C, Shaw J. Comparison of the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients at the emergency department. Diabetes mellitus, fasting glucose, and risk of cause-specific death. Age 18-15 and either 3 cardiac risk factors or known coronary artery disease (previous acute MI, coronary artery bypass graft, or percutaneous coronary. As per CDC study in 2014, Americans living in rural areas are more likely to die from leading causes such as cardiovascular diseases. Rao Kondapally Seshasai S, Kaptoge S, Thompson A, et al. A TIMI risk score 3 recommends early invasive management with cardiac angiography and revascularization. Impact of diabetes mellitus on hospitalization for heart failure, cardiovascular events, and death: outcomes at 4 years from the REduction of Atherothrombosis for Continued Health (REACH) Registry. © 2017 by the American Diabetes Association.Ĭavender MA, Steg PG, Smith SC Jr, et al. The expanded TRS 2°P provides a practical and well-calibrated risk prediction tool for patients with type 2 diabetes. There was close calibration with the type 2 diabetes cohort from the REACH Registry (goodness-of-fit P = 0.78). The C-statistic (0.71 for CV death and 0.66 for the composite end point) was consistent in each subgroup. A clear risk gradient was present within the subgroups of all coronary artery disease (CAD), CAD without prior MI, CAD with prior MI, peripheral artery disease, and prior stroke ( P trend < 0.001 for each), with consistent risk relationships across subgroups. TRS 2°P revealed a robust risk gradient for the composite of CV death, MI, and ischemic stroke in the full trial population, with 2-year event rates of 0.9% in the lowest- and 19.8% in the highest-risk groups ( P trend < 0.001). Calibration was tested in the diabetes cohort from the REACH (REduction of Atherothrombosis for Continued Health) Registry. The Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P) predicts a gradient of risk in patients with prior myocardial infarction (MI) but has not been evaluated in patients with type 2 diabetes.ĬV event rates were compared by baseline TRS 2°P in 16,488 patients enrolled in SAVOR-TIMI 53 (Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53) with type 2 diabetes and high CV risk or established CV disease. All rights reserved.Improved risk assessment for patients with type 2 diabetes and elevated cardiovascular (CV) risk is needed. Physician in the emergency department should be aware of the importance of clinical examination in the risk stratification in patients presenting with ACS.Ĭopyright © 2012 Elsevier Inc. ![]() High Killip class was independent predictors of mortality in ST-elevation myocardial infarction and non-ST-elevation acute coronary syndrome. In conclusion, across ACS, patients with higher Killip class had worse clinical profile and were less likely to be treated with evidence-based therapy. Results: The TIMI risk score at ED presentation successfully risk-stratied this unselected cohort of chest pain patients with respect to 30-day adverse outcome, with a range from 2.1, with a score of 0, to 100, with a score of 7. Classes II, III, and IV were associated with higher adjusted odds of death in ST-elevation myocardial infarction (odds ratio 2.1, 95% confidence interval 1.25-3.69 OR 6.1, 95% CI 3.41-10.86 and OR 28, 95% CI 15.24-54.70, respectively) and non-ST-elevation acute coronary syndrome (adjusted OR 2.4, 95% CI 1.24-4.82 OR 3.2,95% 1.49-7.02 and OR 9.8, 95% CI 3.79-25.57, respectively). In comparison to Killip Class I, patients with higher Killip class had greater prevalence of cardiovascular risk factors, presented late, were less likely to have angina, and were less likely to receive antiplatelet, statins, and β-blockers. High Killip classes were defined in 22% of patients. Patients' characteristics and in-hospital outcomes were analyzed. Patients were categorized according to Killip classification at presentation (Classes I, II, III, and IV). In 2007 and over 5 months, 6704 consecutive patients with ACS were enrolled in the Gulf Registry of Acute Coronary Events. The purpose of this study was to assess the prognostic value of the Killip classification at the presentation in patients with acute coronary syndrome (ACS). ![]()
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