Validation of Age-adjusted Shock indices for Predicting In-hospital outcomes in percutaneously REvascularized ST-elevation myocardial infarction - ASPIRE-STEMI study

The ASPIRE-STEMI study prospectively evaluated 236 patients with ST-elevation myocardial infarction undergoing percutaneous revascularization to validate Age-Shock Index (Age-SI) and Age-Modified Shock Index (Age-MSI) as alternatives to the GRACE score for predicting in-hospital major adverse cardiovascular events (MACE) and all-cause mortality. For MACE (n = 60), optimal cut-offs yielded sensitivities/specificities of 76.7 %/67 % (Age-SI ≥ 36.95), 85 %/56.2 % (Age-MSI ≥45.64), and 60 %/81.9 % (GRACE ≥127.5). For all-cause mortality (n = 17), optimal cut-offs yielded sensitivity/specificity of 82.4 %/83 % (Age-SI ≥46.83), 77 %/89 % (Age-MSI ≥67.35), and 94 %/76.7 % (GRACE ≥127.5). While each index independently predicted in-hospital outcomes, Age-SI and Age-MSI offer simple, bedside risk stratification in Indian STEMI patients post-PCI.