Ability of a novel shock index that incorporates invasive hemodynamics to predict mortality in patients with ST-elevation myocardial infarction.

Autor: McKenzie A; Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Zhou C; Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Svendsen C; Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA., Anketell R; Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA., Behroozi A; Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA., Jessa D; Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA., Piehl C; University of Tennessee, Knoxville, Tennessee, USA., Rayson R; Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Yeung M; Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Stouffer GA; Division of Cardiology and McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2021 Jul 01; Vol. 98 (1), pp. 87-94. Date of Electronic Publication: 2021 Jan 09.
DOI: 10.1002/ccd.29460
Abstrakt: Objective: To determine whether the use of invasively measured hemodynamics improves the prognostic ability of a shock index (SI).
Background: SI such as Admission-SI, Age-SI, Modified SI (MSI), and Age-MSI predict short-term mortality in ST-elevation myocardial infarction (STEMI).
Methods: Single-center study of 510 patients who underwent primary percutaneous coronary intervention. STEMI SI was defined as age × heart rate (HR) divided by coronary perfusion pressure (CPP).
Results: The mean age was 62 ± 14 years, 66% were males with hypertension (69%), tobacco use (38%), diabetes (28%) and chronic kidney disease (6%). The mean HR, systolic blood pressure (SBP), and CPP were 81 ± 18 bpm, 124 ± 28 mmHg, and 52.8 ± 16.3 mmHg, respectively. Patients with STEMI SI ≥182 (n = 51) were more likely to experience a cardiac arrest in the catheterization laboratory (9.8% vs. 2.0%; p = .001), require mechanical circulatory support (47.1% vs. 8.5%; p < .0001) and be treated with vasopressors (56.9% vs. 10.7%; p < .0001) compared to STEMI SI < 182 (n = 459). After multivariate adjustment, patients with STEMI SI ≥182 were 10, 10.1 and 4.8 times more likely to die during hospitalization, at 30 days and at 5 years, respectively. The C statistic of STEMI SI was 0.870, similar to GRACE score (AUC = 0.902; p = .29) and TIMI STEMI score (AUC = 0.895; p = .36).
Conclusion: STEMI SI is an easy to calculate risk score that identifies STEMI patients at high risk of in-hospital death.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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