title: Application of the TIMI risk score in ED patients with cocaine-associated chest pain.
abstract: OBJECTIVE
  The TIMI risk score has been validated as a risk stratification tool in emergency department (ED) patients with potential acute coronary syndrome. The goal of this study was to assess its ability to predict adverse cardiovascular outcomes in cocaine-associated chest pain.
  
  
  METHODS
  This was a prospective cohort study of ED patients with chest pain with cocaine use. Data included demographics, medical history, and TIMI risk score. The main outcomes were acute myocardial infarction, revascularization, or death within 30 days of ED presentation.
  
  
  RESULTS
  There were 261 patient visits. Patients were 43.2+8 years old, 73% male, 92% black, and 75% smokers. There were 33 patients with the composite outcome. The incidence of 30-day outcomes according to TIMI score is as follows: TIMI 0, 3.7% (95% CI, 0.1-8.3); TIMI 1, 13.2% (5.7-20.7); TIMI 2, 17.1% (4.3-29.8); TIMI 3, 21.4% (4.4-38.4); TIMI 4, 20.0% (0.1-43.6); TIMI 5/6, 50.0% (0.1-100).
  
  
  CONCLUSIONS
  The TIMI risk score has no clinically useful predictive value in patients with cocaine-associated chest pain.
authors.affiliation: Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. mchase1@bidmc.harvard.edu
authors.forename: Maureen
authors.initials: M
authors.lastname: Chase
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Brown
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Robey
authors.forename: Kara E
authors.initials: KE
authors.lastname: Zogby
authors.forename: Frances S
authors.initials: FS
authors.lastname: Shofer
authors.forename: Lauren
authors.initials: L
authors.lastname: Chmielewski
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
mesh_terms: D000328:Adult; D002637:Chest Pain / Q000139:chemically induced*; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000150:complications*; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors