Validation of Age-adjusted Shock indices for Predicting In-hospital outcomes in percutaneously REvascularized...

Area of Science:

• Cardiology
• Clinical Research
• Medical Informatics

Background:

• ST-elevation myocardial infarction (STEMI) requires prompt revascularization.
• Accurate prediction of in-hospital outcomes is crucial for patient management.
• Existing risk scores like GRACE may have limitations in certain populations.

Purpose of the Study:

• To prospectively validate the Age-Shock Index (Age-SI) and Age-Modified Shock Index (Age-MSI) in Indian STEMI patients.
• To compare the predictive performance of Age-SI and Age-MSI against the GRACE score for in-hospital MACE and mortality.
• To assess the utility of Age-SI and Age-MSI for bedside risk stratification post-percutaneous coronary intervention (PCI).

Main Methods:

• Prospective evaluation of 236 STEMI patients undergoing PCI.
• Calculation and analysis of Age-SI, Age-MSI, and GRACE scores.
• Determination of optimal cut-off values for predicting major adverse cardiovascular events (MACE) and all-cause mortality.

Main Results:

• Age-SI and Age-MSI demonstrated significant predictive capabilities for both MACE and all-cause mortality.
• Optimal Age-SI cut-offs showed sensitivities/specificities of 76.7%/67% for MACE and 82.4%/83% for mortality.
• Optimal Age-MSI cut-offs showed sensitivities/specificities of 85%/56.2% for MACE and 77%/89% for mortality.
• GRACE score (≥127.5) showed sensitivities/specificities of 60%/81.9% for MACE and 94%/76.7% for mortality.

Conclusions:

• Age-SI and Age-MSI are valuable, simple tools for bedside risk stratification in Indian STEMI patients post-PCI.
• These indices offer a practical alternative to traditional risk scores for predicting in-hospital adverse events.
• Further validation in diverse populations may enhance their clinical applicability.