![]() Your healthcare provider should be able to explain your results in a way that you can easily understand. Talk to your doctor if you have any questions about your TIMI score. keeping cholesterol and blood pressure levels in check.avoiding cigarette smoking and limiting alcohol consumption.You can lower your score, and your risk for a heart-related event, by: For example, if your TIMI score is on the high side, your physician might want to treat your condition more aggressively or pursue other kinds of medical intervention. Your score may help your physician come up with a treatment strategy. Knowing your risk for having a heart attack or other heart-related event can be extremely helpful to your healthcare provider. This means not every person will be given a TIMI score. All rights reserved.Doctors typically use the TIMI score on a select group of people with heart conditions that meet a certain criterion. (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation NCT00007657) (Bypass Angioplasty Revascularization Investigation 2 Diabetes NCT00006305) (Comparison of Two Treatments for Multivessel Coronary Artery Disease in Individuals With Diabetes NCT00086450).Ĭopyright © 2013 American College of Cardiology Foundation. We conclude that fundamentally new thinking is needed to explore approaches to achieve optimal secondary prevention treatment goals. Although similar improved trends were seen for systolic blood pressure, glycemic control, and smoking cessation, only 18% of the COURAGE diabetes subgroup, 23% of BARI 2D patients, and 8% of FREEDOM patients met all 4 pre-specified treatment targets at 1 year of follow-up.Ī significant proportion of diabetic CAD patients fail to achieve pre-specified targets for 4 major modifiable cardiovascular risk factors in clinical trials. The percentages of patients achieving the 1-year low-density lipoprotein cholesterol targets compared with baseline increased from 55% to 77% in COURAGE, from 59% to 75% in BARI 2D, and from 34% to 42% in FREEDOM. The pooled data include 5,034 diabetic patients. The primary outcome measure was the proportion of diabetic CAD patients meeting all 4 pre-specified targets at 1 year after enrollment. We obtained data from the COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) diabetes subgroup, (n = 766 of 2,287), the BARI 2D (Bypass Angioplasty Revascularization Investigation 2 Diabetes) trial (n = 2,368), and the FREEDOM (Comparison of Two Treatments for Multivessel Coronary Artery Disease in Individuals With Diabetes) trial (n = 1,900) to evaluate the proportion of patients achieving guideline-based, protocol-driven treatment targets for systolic blood pressure, low-density lipoprotein cholesterol, smoking cessation, and hemoglobin A1c. This study evaluated data from 3 federally funded trials that focused on optimal medical therapy to determine if formalized attempts at risk factor control within clinical trials are effective in achieving guideline-driven treatment goals for diabetic patients with coronary artery disease (CAD).ĭespite clear evidence of benefit for CAD secondary prevention, the level of risk factor control in clinical practice has been disappointing.
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