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Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry

Sofie Gevaert, Dirk De Bacquer UGent, Patrick Evrard, Carl Convens, Philippe Dubois, Jean Boland, Marc Renard, Christophe Beauloye, Patrick Coussement, Herbert De Raedt, et al. (2014) EUROINTERVENTION. 9(9). p.95-101
abstract
Aims: The relationship between the predictive performance of the TIMI risk score for STEMI and gender has not been evaluated in the setting of primary PCI (pPCI). Here, we compared in-hospital mortality and predictive performance of the TIME risk score between Belgian women and men undergoing pPCI. Methods and results: In-hospital mortality was analysed in 8,073 (1,920 [23.8%] female and 6,153 [76.2%] male patients) consecutive pPCI-treated STEMI patients, included in the prospective, observational Belgian STEMI registry (January 2007 to February 2011). A multivariable logistic regression model, including TIMI risk score variables and gender, evaluated differences in in-hospital mortality between men and women. The predictive performance of the TIMI risk score according to gender was evaluated in terms of discrimination and calibration. Mortality rates for TIMI scores in women and men were compared. Female patients were older, had more comorbidities and longer ischaemic times. Crude in-hospital mortality was 10.1% in women vs. 4.9% in men (OR 2.2; 95% CI: 1.82-2.66, p<0.001). When adjusting for TIMI risk score variables, mortality remained higher in women (OR 1.47, 95% CI: 1.15-1.87, p=0.002). The TIME risk score provided a good predictive discrimination and calibration in women as well as in men (c-statistic=0.84 [95% CI: 0.809-0.866], goodness-of-fit p=0.53 and c-statistic=0.89 [95% CI: 0.873-0.907], goodness-of-fit p=0.13, respectively), but mortality prediction for TIMI scores was better in men (p=0.02 for TINE score x gender interaction). Conclusions: In the Belgian STEMI registry, pPCI-treated women had a higher in-hospital mortality rate even after correcting for TIMI risk score variables. The TIMI risk score was effective in predicting in-hospital mortality but performed slightly better in men. The database was registered with clinicaltrials.gov (NCT00727623).
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
WOMEN, ERA, TRIAL, MEN, OUTCOMES, NATIONAL REGISTRY, PRIMARY ANGIOPLASTY, SEX-BASED DIFFERENCES, PERCUTANEOUS CORONARY INTERVENTION, ACUTE MYOCARDIAL-INFARCTION, TIMI risk score, STEMI, primary PCI, in-hospital mortality, gender
journal title
EUROINTERVENTION
EuroIntervention
volume
9
issue
9
pages
95 - 101
Web of Science type
Article
Web of Science id
000332194800015
JCR category
CARDIAC & CARDIOVASCULAR SYSTEMS
JCR impact factor
3.769 (2014)
JCR rank
35/123 (2014)
JCR quartile
2 (2014)
ISSN
1774-024X
DOI
10.4244/EIJV919A184
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
5764632
handle
http://hdl.handle.net/1854/LU-5764632
date created
2014-11-27 12:11:05
date last changed
2017-09-05 14:21:35
@article{5764632,
  abstract     = {Aims: The relationship between the predictive performance of the TIMI risk score for STEMI and gender has not been evaluated in the setting of primary PCI (pPCI). Here, we compared in-hospital mortality and predictive performance of the TIME risk score between Belgian women and men undergoing pPCI. 
Methods and results: In-hospital mortality was analysed in 8,073 (1,920 [23.8\%] female and 6,153 [76.2\%] male patients) consecutive pPCI-treated STEMI patients, included in the prospective, observational Belgian STEMI registry (January 2007 to February 2011). A multivariable logistic regression model, including TIMI risk score variables and gender, evaluated differences in in-hospital mortality between men and women. The predictive performance of the TIMI risk score according to gender was evaluated in terms of discrimination and calibration. Mortality rates for TIMI scores in women and men were compared. Female patients were older, had more comorbidities and longer ischaemic times. Crude in-hospital mortality was 10.1\% in women vs. 4.9\% in men (OR 2.2; 95\% CI: 1.82-2.66, p{\textlangle}0.001). When adjusting for TIMI risk score variables, mortality remained higher in women (OR 1.47, 95\% CI: 1.15-1.87, p=0.002). The TIME risk score provided a good predictive discrimination and calibration in women as well as in men (c-statistic=0.84 [95\% CI: 0.809-0.866], goodness-of-fit p=0.53 and c-statistic=0.89 [95\% CI: 0.873-0.907], goodness-of-fit p=0.13, respectively), but mortality prediction for TIMI scores was better in men (p=0.02 for TINE score x gender interaction). 
Conclusions: In the Belgian STEMI registry, pPCI-treated women had a higher in-hospital mortality rate even after correcting for TIMI risk score variables. The TIMI risk score was effective in predicting in-hospital mortality but performed slightly better in men. The database was registered with clinicaltrials.gov (NCT00727623).},
  author       = {Gevaert, Sofie and De Bacquer, Dirk and Evrard, Patrick and Convens, Carl and Dubois, Philippe and Boland, Jean and Renard, Marc and Beauloye, Christophe and Coussement, Patrick and De Raedt, Herbert and de Meester, Antoine and Vandecasteele, Els and Vranckx, Pascal and Sinnaeve, Peter R and Claeys, Marc J},
  issn         = {1774-024X},
  journal      = {EUROINTERVENTION},
  keyword      = {WOMEN,ERA,TRIAL,MEN,OUTCOMES,NATIONAL REGISTRY,PRIMARY ANGIOPLASTY,SEX-BASED DIFFERENCES,PERCUTANEOUS CORONARY INTERVENTION,ACUTE MYOCARDIAL-INFARCTION,TIMI risk score,STEMI,primary PCI,in-hospital mortality,gender},
  language     = {eng},
  number       = {9},
  pages        = {95--101},
  title        = {Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry},
  url          = {http://dx.doi.org/10.4244/EIJV919A184},
  volume       = {9},
  year         = {2014},
}

Chicago
GEVAERT, SOFIE, Dirk De Bacquer, Patrick Evrard, Carl Convens, Philippe Dubois, Jean Boland, Marc Renard, et al. 2014. “Gender, TIMI Risk Score and In-hospital Mortality in STEMI Patients Undergoing Primary PCI: Results from the Belgian STEMI Registry.” Eurointervention 9 (9): 95–101.
APA
GEVAERT, S., De Bacquer, D., Evrard, P., Convens, C., Dubois, P., Boland, J., Renard, M., et al. (2014). Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry. EUROINTERVENTION, 9(9), 95–101.
Vancouver
1.
GEVAERT S, De Bacquer D, Evrard P, Convens C, Dubois P, Boland J, et al. Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry. EUROINTERVENTION. 2014;9(9):95–101.
MLA
GEVAERT, SOFIE, Dirk De Bacquer, Patrick Evrard, et al. “Gender, TIMI Risk Score and In-hospital Mortality in STEMI Patients Undergoing Primary PCI: Results from the Belgian STEMI Registry.” EUROINTERVENTION 9.9 (2014): 95–101. Print.