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Expanded TIMI Risk Score Deemed Practical in Diabetes

FRIDAY, Dec. 15, 2017 -- The TIMI (Thrombolysis in Myocardial Infarction) Risk Score for Secondary Prevention (TRS 2°P) is an accurate predictor of atherothrombotic disease among patients with type 2 diabetes, according to a study published online Dec. 1 in Diabetes Care.

Brian A. Bergmark, M.D., from Brigham and Women's Hospital in Boston, and colleagues assessed the TRS 2°P in patients with type 2 diabetes by comparing baseline TRS 2°P in a cohort of 16,488 patients (participating in SAVOR-TIMI 53) with type 2 diabetes and high cardiovascular (CV) risk or established CV disease.

The researchers found that TRS 2°P resulted in a robust risk gradient for the composite outcome of CV death, myocardial infarction (MI), and ischemic stroke. Among the full cohort, two-year event rates were 0.9 percent in the lowest- and 19.8 percent in the highest-risk groups (Ptrend < 0.001). Within subgroups, including all coronary artery disease (CAD), CAD without prior MI, CAD with prior MI, peripheral artery disease, and prior stroke, a clear risk gradient was detected (Ptrend < 0.001 for each). Similar results were seen with the type 2 diabetes cohort from the REACH Registry (goodness-of-fit P = 0.78).

"The expanded TRS 2°P provides a practical and well-calibrated risk prediction tool for patients with type 2 diabetes," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including AstraZeneca and Bristol-Myers Squibb, which funded the study.

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Posted: December 2017