Predicting the development of in-hospital cardiogenic shock in patients with ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: the ORBI risk score
| Autor: | Isabelle Coudert, Marianne Zeller, Romain Didier, Frédéric Chagué, Jean-Claude Beer, Jean-Christophe Cornily, Emanuelle Filippi, Rishi Puri, Amer Zabalawi, Vincent Auffret, Hervé Le Breton, Orbi, Guillaume Leurent, Damien Brunet, Jean-Philippe Hacot, Maud Maza, Yves Cottin, Marielle Le Guellec, Marc Bedossa, Philippe Brunel, Emilie Bot, B. Boulanger, Mourad Mejri, Gilles Rouault, Luc Lorgis, Aurélie Loirat, Martine Gilard, Dominique Boulmier, Philippes Druelles |
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| Přispěvatelé: | Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes], CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), CHU de Saint-Brieuc, CHU Dijon, Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Daiichi-Sankyo, University Hospital of Dijon, Association de Cardiologie de Bourgogne, Agence Regionale de Sante (ARS) de Bourgogne-Franche Comte, French Ministry of Research, Institut National de la Sante et de la Recherche Medicale (INSERM), Conseil Regional de Bourgogne-Franche Comte, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Shock Cardiogenic 030204 cardiovascular system & hematology Risk Assessment Peripheral Arterial Disease 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Internal medicine medicine Humans Registries 030212 general & internal medicine Myocardial infarction 10. No inequality Cardiogenic shock Stroke Aged Killip class Aged 80 and over Framingham Risk Score Predictors business.industry Age Factors Percutaneous coronary intervention Thrombolysis Middle Aged Prognosis medicine.disease Heart Arrest 3. Good health ST-segment elevation myocardial infarction Logistic Models Hypertension Cohort Cardiology ST Elevation Myocardial Infarction Risk score [SDV.IB]Life Sciences [q-bio]/Bioengineering Female France Cardiology and Cardiovascular Medicine business |
| Zdroj: | European Heart Journal European Heart Journal, Oxford University Press (OUP): Policy B, 2018, 39 (22), pp.2090-+. ⟨10.1093/eurheartj/ehy127⟩ European Heart Journal, 2018, 39 (22), pp.2090-+. ⟨10.1093/eurheartj/ehy127⟩ |
| ISSN: | 1522-9645 0195-668X |
| Popis: | International audience; Aims To derive and validate a readily useable risk score to identify patients at high-risk of in-hospital ST-segment elevation myocardial infarction (STEMI)-related cardiogenic shock (CS). Methods and results In all, 6838 patients without CS on admission and treated by primary percutaneous coronary intervention (pPCI), included in the Observatoire Regional Breton sur l'Infarctus (ORBI), served as a derivation cohort, and 2208 patients included in the obseRvatoire des Infarctus de Cote-d'Or (RICO) constituted the external validation cohort. Stepwise multivariable logistic regression was used to build the score. Eleven variables were independently associated with the development of in-hospital CS age >70 years, prior stroke/transient ischaemic attack, cardiac arrest upon admission, anterior STEMI, first medical contact-to-pPCI delay >90 min, Killip class, heart rate >90/min, a combination of systolic blood pressure 10 mmol/L, culprit lesion of the left main coronary artery, and post-pPCI thrombolysis in myocardial infarction flow grade = 13). Observed in-hospital CS rates were 1.3%, 6.6%, 11.7%, and 31.8%, across the four risk categories, respectively. Validation in the RICO cohort demonstrated in-hospital CS rates of 3.1% (score 0-7), 10.6% (score 8-10), 18.1% (score 11-12), and 34.1% (score >= 13). The score demonstrated high discrimination (c-statistic of 0.84 in the derivation cohort, 0.80 in the validation cohort) and adequate calibration in both cohorts. Conclusion The ORBI risk score provides a readily useable and efficient tool to identify patients at high-risk of developing CS during hospitalization following STEMI,which may aid in further risk-stratification and thus potentially facilitate pre-emptive clinical decision making. |
| Databáze: | OpenAIRE |
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