title: An Asian validation of the TIMI risk score for ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Risk stratification in ST-elevation myocardial infarction (STEMI) is important, such that the most resource intensive strategy is used to achieve the greatest clinical benefit. This is essential in developing countries with wide variation in health care facilities, scarce resources and increasing burden of cardiovascular diseases. This study sought to validate the Thrombolysis In Myocardial Infarction (TIMI) risk score for STEMI in a multi-ethnic developing country.
  
  
  METHODS
  Data from a national, prospective, observational registry of acute coronary syndromes was used. The TIMI risk score was evaluated in 4701 patients who presented with STEMI. Model discrimination and calibration was tested in the overall population and in subgroups of patients that were at higher risk of mortality; i.e., diabetics and those with renal impairment.
  
  
  RESULTS
  Compared to the TIMI population, this study population was younger, had more chronic conditions, more severe index events and received treatment later. The TIMI risk score was strongly associated with 30-day mortality. Discrimination was good for the overall study population (c statistic 0.785) and in the high risk subgroups; diabetics (c statistic 0.764) and renal impairment (c statistic 0.761). Calibration was good for the overall study population and diabetics, with χ2 goodness of fit test p value of 0.936 and 0.983 respectively, but poor for those with renal impairment, χ2 goodness of fit test p value of 0.006.
  
  
  CONCLUSIONS
  The TIMI risk score is valid and can be used for risk stratification of STEMI patients for better targeted treatment.
authors: Clinical Epidemiology Unit, Clinical Research Centre, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia. s.selvarajah@umcutrecht.nl
authors: Sharmini
authors: S
authors: Selvarajah
authors: Alan Yean Yip
authors: AY
authors: Fong
authors: Gunavathy
authors: G
authors: Selvaraj
authors: Jamaiyah
authors: J
authors: Haniff
authors: Cuno S P M
authors: CS
authors: Uiterwaal
authors: Michiel L
authors: ML
authors: Bots
mesh_terms: D000368:Aged; D001777:Blood Coagulation; D003920:Diabetes Mellitus / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods*