Evidence map›Paper›PMID 40435009›Full record

ArticleArquivos brasileiros de cardiologia2025

TIMI Risk Score for Secondary Prevention to Risk Stratify Chronic Coronary Syndrome Patients: External Validation Study.

Henrique Trombini Pinesi, Eduardo Martelli Moreira, Marcelo Henrique Moreira Barbosa, Fabio Grunspun Pitta, Fabiana Hanna Rached, Eduardo Gomes Lima, Eduardo Bello Martins, Carlos Vicente Serrano

Abstract readValidation Study
In one paragraph

Article in Arquivos brasileiros de cardiologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Henrique Trombini PinesiInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0002-3973-7523
Eduardo Martelli MoreiraInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0002-7404-2110
Marcelo Henrique Moreira BarbosaInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Fabio Grunspun PittaInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0001-7574-757X
Fabiana Hanna RachedInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.
Eduardo Gomes LimaInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0001-8501-9867
Eduardo Bello MartinsInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0001-8752-2175
Carlos Vicente SerranoInstituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brasil.ORCID 0000-0002-9171-1224

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRisk stratification in chronic coronary syndrome (CCS) patients is challenging. TIMI Risk Score for Secondary Prevention (TRS2P) is a simple nine-point tool developed to predict cardiovascular death, myocardial infarction (MI), and ischemic stroke among post-MI patients. No studies have been conducted on it in the Brazilian population.

objectiveValidate the TRS2P score among CCS patients at a tertiary center in Brazil.

methodsThis is a registry-based study of patients with CCS, defined as having a previous revascularization procedure, previous MI, or ≥50% stenosis in at least one epicardial coronary artery. The primary outcome was the three-year incidence of MACE (death, MI or stroke). The predicted risk was as reported in the original derivation study. Calibration was assessed through a calibration plot and the Hosmer-Lemeshow test. Discrimination was evaluated through the concordance (C)-statistic. A significance level of 0.05 was adopted.

resultsThe study sample consisted of 515 patients. There were 173 (34%) women, 75 (15%) aged over 75 years, 298 (58%) had diabetes, and 156 (30%) had chronic kidney disease. During follow-up, 126 MACE were documented. The estimated three-year incidence was 24% (95% confidence interval [CI] 21%-28%), whereas the predicted incidence was 15%. Although higher TRS2P scores were associated with higher MACE incidence, the TRS2P risk score model underestimated MACE incidence at every strata (p < 0.01). The C-statistic was 0.64 (95% CI 0.58-0.69).

conclusionThe TRS2P score identifies patients with a higher risk of cardiovascular events but it underestimated MACE and presented poor discrimination in a Brazilian CCS cohort.

Indexed as

Coronary DiseaseHeart Disease Risk FactorsSecondary PreventionAgedAged, 80 and overBrazilChronic DiseaseFemaleHumansIncidenceMaleRisk

Identifiers

PMID40435009
PMCPMC12129484

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.