BACKGROUND: Primary percutaneous coronary intervention (PCI) has become the preferred reperfusion strategy in patients with ST-segment elevation myocardial infarction and cardiogenic shock. Early identification of patients at risk for developing cardiogenic shock allows rapid decision making to determine reperfusion and transportation to a PCI centre. The aim of this analysis was to evaluate shock index (SI) as a marker for patients at risk of cardiogenic shock. METHODS: A total of 644 consecutive patients (73% male) with acute myocardial infarction with ST elevations were analyzed retrospectively. Primary PCI was performed in 92% of patients, and 7% of patients underwent rescue PCI. The SI parameter was defined as the ratio of heart rate to systolic blood pressure at hospital admission. RESULTS: SI (odds ratio [OR], 81.26; 95% confidence interval [CI], 9.76-676.51; P<0.001), age (OR, 1.17; 95% CI, 1.08-1.26; P<0.001), and diabetes (OR, 4.94; 95% CI, 1.44-16.97; P<0.011) were independent predictors of mortality. In the group of patients with SI≥0.8, 20% died, whereas in the group with SI<0.8, 4% of patients died (P<0.01). CONCLUSIONS: The proposed clinical parameter SI correlates with patients' prognosis and could therefore be used as a simple indicator of mortality risk of acute myocardial infarction. The simplicity of this proposed index makes its use accessible in large-scale clinical practices for risk stratification during first contact with patients.
BACKGROUND: Primary percutaneous coronary intervention (PCI) has become the preferred reperfusion strategy in patients with ST-segment elevation myocardial infarction and cardiogenic shock. Early identification of patients at risk for developing cardiogenic shock allows rapid decision making to determine reperfusion and transportation to a PCI centre. The aim of this analysis was to evaluate shock index (SI) as a marker for patients at risk of cardiogenic shock. METHODS: A total of 644 consecutive patients (73% male) with acute myocardial infarction with ST elevations were analyzed retrospectively. Primary PCI was performed in 92% of patients, and 7% of patients underwent rescue PCI. The SI parameter was defined as the ratio of heart rate to systolic blood pressure at hospital admission. RESULTS: SI (odds ratio [OR], 81.26; 95% confidence interval [CI], 9.76-676.51; P<0.001), age (OR, 1.17; 95% CI, 1.08-1.26; P<0.001), and diabetes (OR, 4.94; 95% CI, 1.44-16.97; P<0.011) were independent predictors of mortality. In the group of patients with SI≥0.8, 20% died, whereas in the group with SI<0.8, 4% of patients died (P<0.01). CONCLUSIONS: The proposed clinical parameter SI correlates with patients' prognosis and could therefore be used as a simple indicator of mortality risk of acute myocardial infarction. The simplicity of this proposed index makes its use accessible in large-scale clinical practices for risk stratification during first contact with patients.
Authors: Sameh W Almousa; Mark N Belkin; Tess Allan; Allison Stephens; Joseph Kern; Miryea Cisneros; Janet Friant; Cynthia Arevalo; Sandeep Nathan; Atman P Shah; Jonathan Paul; Rohan Kalathiya; Jonathan Grinstein; John E A Blair Journal: J Invasive Cardiol Date: 2021-06-16 Impact factor: 2.022
Authors: José Rojas-Suarez; Ángel Paternina-Caicedo; Jorge E Tolosa; Leidy Guzmán-Polanía; Nataly Gonzalez; Fredy Pomares; Augusto Maza; Jezid Miranda Journal: Obstet Med Date: 2019-04-26
Authors: Zainali S Chunawala; Michael E Hall; Sameer Arora; Xuming Dai; Venu Menon; Sidney C Smith; Kunihiro Matsushita; Melissa C Caughey Journal: Eur Heart J Acute Cardiovasc Care Date: 2021-10-27
Authors: Phyo Kyaw Myint; Shubin Sheng; Ying Xian; Roland A Matsouaka; Mathew J Reeves; Jeffrey L Saver; Deepak L Bhatt; Gregg C Fonarow; Lee H Schwamm; Eric E Smith Journal: J Am Heart Assoc Date: 2018-09-18 Impact factor: 5.501