Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment...

Area of Science:

• Cardiology
• Clinical Risk Stratification
• Interventional Cardiology

Background:

• ST-segment elevation myocardial infarction (STEMI) is a critical condition requiring timely intervention.
• Accurate prediction of adverse outcomes in STEMI patients undergoing primary percutaneous coronary intervention (PCI) is crucial for guiding treatment and improving prognosis.
• The Thrombolysis In Myocardial Infarction (TRI) risk index is established, but novel predictive markers are continuously sought.

Purpose of the Study:

• To compare the prognostic value of the shock index (SI) and its derivatives against the TRI for predicting adverse outcomes.
• To evaluate the efficacy of age-adjusted SI (age SI) and age modified SI (age MSI) in STEMI patients undergoing primary PCI.

Main Methods:

• Retrospective cohort study of 257 STEMI patients undergoing primary PCI.
• Calculation of SI, modified SI (MSI), age SI, age MSI, and TRI at admission.
• Assessment of clinical endpoints including in-hospital complications (mortality, heart failure, shock, re-infarction, arrhythmia).

Main Results:

• High SI, MSI, age SI, age MSI, and TRI were significantly associated with increased in-hospital complications.
• The predictive performance of age SI and age MSI for in-hospital complications was comparable to TRI.
• Receiver operating characteristic curve analysis indicated similar predictive value between age SI/age MSI and TRI.

Conclusions:

• Age-adjusted SI and age MSI demonstrate similar prognostic capability to TRI in predicting in-hospital complications.
• These findings suggest that age-adjusted SI and age MSI are valuable tools for risk stratification in STEMI patients undergoing primary PCI.
• Further prospective studies are warranted to validate these results and explore their clinical utility.