![]() Percutaneous coronary intervention and adjunctive pharmacotherapy in women: a statement for healthcare professionals from the American Heart Association. Lansky AJ, Hochman JS, Ward PA, Mintz GS, Fabunmi R, Berger PB, et al. GRACE Score among Six Risk Scoring Systems (CADILLAC, PAMI, TIMI, Dynamic TIMI, Zwolle) Demonstrated the Best Predictive Value for Prediction of Long-Term Mortality in Patients with ST-Elevation Myocardial Infarction. Littnerova S, Kala P, Jarkovsky J, Kubkova L, Prymusova K, Kubena P, et al. ![]() Effectiveness of primary percutaneous coronary intervention compared with that of thrombolytic therapy in elderly patients with acute myocardial infarction. Mehta RH, Sadiq I, Goldberg RJ, Gore JM, Avezum Á, Spencer F, et al. Trends in presenting characteristics and hospital mortality among patients with ST elevation and non-ST elevation myocardial infarction in the National Registry of Myocardial Infarction from 1990 to 2006. Rogers WJ, Frederick PD, Stoehr E, Canto JG, Ornato JP, Gibson CM, et al. Therefore, the prognostic TIMI risk score is a robust tool in predicting both in-hospital as well as post-discharge mortality in elderly females. ![]() Increased adverse outcomes were observed with higher TIMI risk score for in hospital and post-discharge follow-up. The predictive values (area under the curve) of TIMI risk score for in-hospital and post-discharge mortality were 0.709 (95% CI 0.591-0.827 p <0.001) and 0.689 (95% CI 0.608-0.770 p <0.001), respectively. The mortality rate increased from 5.6% at the score of 0-4 to 54.5% at the score of 8. On follow-up (16.43☗.40 months) of 211 (55.8%) patients, the overall mortality rate was 20.3%, and this was also associated with TIMI score (p<0.001). The in-hospital mortality rate increased from 3.1% at TIMI score of 0-4 to 34.6% at the score of 8. In-hospital mortality rate was 6.4% (26) and was found to be associated with TIMI score (p<0.001). The mean TIMI score was 5.25☑.45 with 40.3% (163) patients of TIMI score > 5. The primary outcome was in-hospital mortality and post-discharge mortality reported on telephonic follow-up.Ī total of 404 elderly women with a median age of 70 years were included. Patients' demographic details and elements of TIMI risk score including age, co-morbidities, Killip classification weight, anterior MI and total ischemic time were extracted from hospital records. This was a retrospective analysis of elderly (>65 years) female patients who underwent PPCI for ST-elevated myocardial infarction (STEMI) from October 2016 to September 2018. This study was conducted to validate the predictive value of Thrombolysis in Myocardial Infarction (TIMI) risk score in elderly female patients. Meta-regression showed a strong linear relationship between TIMI risk score and cumulative incidence of cardiac events (p<0.001).Despite women undergoing primary percutaneous coronary intervention (PPCI) having a higher rate of adverse outcomes than men, data evaluating prognostic risk scores, especially in elderly women, remains scarce. There was significant interaction between prevalence and diagnostic accuracy at TIMI thresholds of more than zero and more than 1. Where reported, highly statistically significant heterogeneity was observed. Negative likelihood ratio increased as the TIMI threshold increased, from 0.11 (95% CI 0.09 to 0.15) when the cut off was more than zero to 0.69 (95% CI 0.67 to 0.71) when the cut off was more than 4. Positive likelihood ratio increased as the TIMI threshold increased, from 1.30 (95% CI 1.28 to 1.31) when the cut off was more than zero to 9.70 (95% CI 8.7 to 10.8) when the cut off was 4. Specificity increased as the TIMI threshold increased, from 25.0% (95% CI 24.3% to 25.7%) when the cut off was more than zero to 96.6% (95% CI 96.3% to 96.9%) when the cut off was more than 4. Sensitivity decreased as the TIMI threshold increased, from 97.2% (95% CI 96.4% to 97.8%) when the cut off was more than zero to 33.2% (95% CI 31.3% to 35.3%) when the cut off was more than 4. Only one study reported assessing the outcome blinded to predictor variables. Eight studies reported adequate follow-up (<10% loss). Three studies gave an explicit interpretation of the risk score by clinicians in practice blinded to outcome. Seven studies reported accurate definitions of outcomes. All studies recruited a representative patient spectrum in an unbiased fashion and assessed the predictor variable blinded to outcome. Ten studies were included in the review (n=17,265) and eight studies were included in the meta-analysis.
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