However, with the limited strength of evidence, these results should be interpreted with caution. The evidence synthesis was limited due to the relatively low quality and heterogeneity of the available studies.Ĭonclusion: Both TIMI and GRACE risk scores demonstrated good predictive accuracies in the population. However, the method of predictive accuracy measurement in most studies was insufficient thereby contributing to the mixed accuracy effect. Recalibrated and new models demonstrated marginal improvements in discriminative values. The pooled estimate of the C-statistic in the Southeast Asian population for GRACE risk score is 0.83 (95%CI 0.72–0.90, n = 6 validations) and for the TIMI risk score is 0.80 (95%CI: 0.772–0.83, n = 5 validations). Overall, we observed that the external validation studies provided a good predictive accuracy of the models in the respective populations. Both short- and long-term outcomes were assessed. Results: We included 7 studies with 11 external validations, 3 recalibrations, and 3 new models from 4 countries. The CHARMS and PRISMA checklists and PROBAST for risk of bias assessment were used in this review. We included prospective and retrospective cohort studies that exclusively evaluated populations in the Southeast Asian region with a confirmed diagnosis of an AMI event and evaluated for risk of secondary events such as mortality, recurrent AMI, and heart failure admission. Methods: We searched MEDLINE and Cochrane Central databases until March 2022. Objectives: We aimed to evaluate the predictive performances of validated, recalibrated, and developed prognostic risk prediction tools used in the Southeast Asian population with acute myocardial infarction (AMI) events for secondary events 3Department of Cardiology, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysiaīackground: The cultural and genetic diversity of the Southeast Asian population has contributed to distinct cardiovascular disease risks, incidence, and prognosis compared to the Western population, thereby raising concerns about the accuracy of predicted risks of existing prognostic models.
2Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.1Nutrition, Metabolic and Cardiovascular Research Centre, Institute for Medical Research, National Institutes of Health, Shah Alam, Malaysia.Sophia Rasheeqa Ismail 1,2 Muhamad Khairul Nazrin Khalil 1 Mohd Shawal Faizal Mohamad 3 Shamsul Azhar Shah 2 *
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