Author + information
- Brian Bergmark,
- Deepak Bhatt,
- Erin Bohula,
- David Morrow,
- Philippe Steg,
- Ofri Mosenzon,
- Itamar Raz,
- Eugene Braunwald and
- Benjamin Scirica
Background: Improved risk assessment for patients with diabetes and elevated CV risk is needed. The TIMI Risk Score for Secondary Prevention (TRS 2°P) predicts a gradient of risk in patients with prior MI, including recent ACS. TRS 2°P has not been evaluated in diabetic patients without prior MI or other CV disease.
Methods: CV event rates were compared by baseline TRS 2°P score in 16,492 patients enrolled in the SAVOR-TIMI 53 trial with diabetes and either multiple CV risk factors (MRF) or pre-existing CV disease. Risk stratification was evaluated by the presence of MRF only, CAD without prior MI, or CAD with prior MI.
Results: TRS 2°P showed robust risk stratification for the composite of CV death, MI, or ischemic stroke within the subgroups of MRF alone and CAD with and without prior MI (p-trend <0.001 for each subgroup) (Fig 1A). The degree of risk stratification was similar across subgroups (p-interaction=0.22). A clear risk gradient was present in the full trial population, with 2-year event rates for the composite end point of 3.0%, 5.6%, and 12.0% in the lowest, middle, and highest risk groups, respectively (p-trend <0.001) (Fig 1B). C-statistic was comparable to other clinical risk scores (0.64 for composite end point and 0.69 for CV death). There was no interaction with saxagliptin (p-interaction=0.66).
Conclusions: The newly described TIMI Risk Score for Secondary Prevention identifies a strong gradient of risk for CV events in stable patients with diabetes, including patients without prior MI or other CV disease.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:15 a.m.-10:25 a.m.
Session Title: Post-CAD/MI: Making Tough Predictions About the Future
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1138M-05
- 2017 American College of Cardiology Foundation