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Published on: August 16, 2021

In-Hospital and Long-Term Clinical Outcomes in Patients With Acute Myocardial Infarction Categorized as SCAI Shock

Hisashi Sato1, Kenichi Sakakura1, Hiroyuki Jinnouchi1

  • 1Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University Saitama Japan.

Circulation Reports
|June 11, 2026
PubMed

Insights

Patients with acute myocardial infarction and cardiogenic shock (CS) in SCAI stage B did not have worse outcomes than stage A. This study found no independent association between modified stage B and adverse in-hospital or long-term cardiovascular events.

Area of Science:

  • Cardiology
  • Clinical Outcomes Research
  • Cardiovascular Medicine

Background:

  • Acute myocardial infarction (AMI) with cardiogenic shock (CS) has a high mortality rate.
  • Mechanical circulatory support (MCS) has advanced, but outcomes remain poor.
  • The Society for Cardiovascular Angiography and Interventions (SCAI) developed a 5-stage CS classification.

Purpose of the Study:

  • To compare clinical outcomes between AMI patients in SCAI shock modified stage A and modified stage B.
  • To evaluate the association of modified SCAI shock stage B with in-hospital and long-term adverse events.

Main Methods:

  • Retrospective analysis of 257 AMI patients classified into modified stage A (n=180) and modified stage B (n=77).
  • Primary endpoint: in-hospital adverse events (death, MCS initiation, mechanical complications).
  • Secondary endpoint: long-term major adverse cardiovascular events (MACE) over a median 786-day follow-up.

Main Results:

  • Modified stage B patients had significantly lower left ventricular ejection fraction (44.6% vs. 54.4%, P<0.001).
  • In-hospital adverse events were comparable between groups (P=0.128).
  • Modified stage B showed a higher incidence of MACE (P=0.029) on Kaplan-Meier analysis, but not in multivariate analyses.

Conclusions:

  • Modified SCAI shock stage B was not independently associated with in-hospital adverse events.
  • Modified SCAI shock stage B was not independently associated with long-term MACE after controlling for confounding factors.
Abstract

Keywords:
Acute myocardial infarctionCardiogenic shockIn-hospital adverse eventsMajor adverse cardiovascular events (MACE)Society for Cardiovascular Angiography and Interventions (SCAI) shock stage classification

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