# Diagnostic Performance of the Thrombolysis in Myocardial Infarction (TIMI) Risk Score in Predicting Angiographic Triple Vessel Disease Among Patients With Non-ST-Segment Elevation Myocardial Infarction

## TL;DR

This study evaluates how well the TIMI risk score can predict three-vessel heart disease in patients with a specific type of heart attack.

## Contribution

The study provides new diagnostic performance metrics for the TIMI score in predicting triple vessel disease in NSTEMI patients.

## Key findings

- The TIMI score had a high positive predictive value (92.6%) but low negative predictive value (28.6%) for predicting TVD.
- Patients with TVD had significantly higher TIMI scores compared to others (p<0.001).

## Abstract

Background

Patients with non-ST-segment elevation myocardial infarction (NSTEMI) often have three vessel disease (TVD). The Thrombolysis in Myocardial Infarction (TIMI) risk score is a commonly used bedside tool for risk stratification; however, its diagnostic accuracy for predicting TVD remains uncertain. Therefore, this study was conducted to assess the diagnostic performance of the TIMI score in the prediction of TVD among patients with NSTEMI with coronary angiography as the reference standard.

Material and methods

A total of 185 patients with NSTEMI were included in this cross-sectional study. TIMI risk scores were assessed on admission, and the patients underwent coronary angiography. Diagnostic performance was then evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results

The mean age of the cohort was 62.78±9.29 years, and 70.3% were male patients. TVD was angiographically validated in 85.4% of patients. Using a TIMI score > 4, the sensitivity was 71.5%, specificity 66.7%, PPV 92.6%, and NPV 28.6%. Post hoc analysis revealed significantly higher TIMI scores in patients with TVD (p<0.001), male patients (p=0.032), diabetics (p=0.041), and urban residents (p=0.028).

Conclusion

The TIMI score demonstrates moderate diagnostic performance for predicting TVD in patients with NSTEMI, with high PPV but low NPV. It could be a useful preliminary screening method; however, it cannot substitute angiography for a final, definite diagnosis.