Scoring and risk stratification (part 1)

Here is a bonus post to make up for the lack of posts over the past few weeks and to celebrate The WM being on the cusp of 5000 views!

The TIMI risk score  is a risk stratification score which prognosticates a patient’s risk of death and ischemic events following unstable angina or NSTEMI. The mnemonic “AMERICA” for this score was derived by Cattermole (see this article: http://www.ncbi.nlm.nih.gov/pubmed/18212165):

A = Age over 65

M =Markers (elevated cardiac markers)

E = EKG (ST changes 0.5 mm)

R = Risk factors (Hypertension, family history [coronary artery disease in father <55 yo and mother <65 yo], hypercholesterolemia, diabetes, smoking, obesity, metabolic syndrome)

I = Ischemia (i.e. 2 or more episodes of angina within the last 24 hours)

C = Coronary artery disease with known lesions greater than 50%

A = Patient has used aspirin within the last 7 days

 

The CHADS2 score is used to calculate a patient’s risk of stroke in atrial fibrillation and their need for anti-coagulation. Each letter is worth 1 point except for the “S”, which is worth 2 points. A score of 2 or more is indicated for anti-coagulated with warfarin.

C = Congestive heart failure

H = Hypertension (blood pressure above 140/90 or known treated hypertension)

A = Age over 75 yo

D = Diabetes mellitus

S2 = Stroke or transient ischemic attack or thromboembolism

 

Before starting warfarin, remember to balance the risk-benefit of starting a blood thinner with the risk of bleeding (see the HAS-BLED score next week)

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Have a great weekend!

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One thought on “Scoring and risk stratification (part 1)

  1. Pingback: Your submissions | The Weekly Mnemonic

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