Key result
The age shock index and age modified shock index had comparable predictive value to the TRI for predicting in-hospital complications in STEMI patients (AUC comparison z=1.313 and z=0.882).
Why the study?
It was unclear whether the prognostic value of the shock index and its derivatives is superior to the Thrombolysis In Myocardial Infarction risk index for predicting adverse outcomes in STEMI patients undergoing primary PCI.
Do shock index-based risk indices predict in-hospital complications better than the TRI in patients with STEMI undergoing primary PCI?
Cohort (n=257)
Do shock index-based risk indices predict in-hospital complications better than the TRI in patients with STEMI undergoing primary PCI?
Age-adjusted shock indices (age SI and age MSI) offer comparable prognostic value to the TRI for predicting in-hospital complications in STEMI patients undergoing primary PCI.
Shock index derivatives show similar predictive value to TRI in STEMI; hypothesis-generating and should not yet change practice.
OBJECTIVE: We aimed to determine whether the prognostic value of the shock index (SI) and its derivatives is better than that of the Thrombolysis In Myocardial Infarction risk index (TRI) for predicting adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: A total of 257 patients with STEMI undergoing primary PCI from January 2018 to June 2019 were analyzed in a retrospective cohort study. The SI, modified shock index (MSI), age SI (age × the SI), age MSI (age × the MSI), and TRI at admission were calculated. Clinical endpoints were in-hospital complications, including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia. RESULTS: Multivariate analyses showed that a high SI, MSI, age SI, age MSI, and TRI at admission were associated with a significantly higher rate of in-hospital complications. The predictive value of the age SI and age MSI was comparable with that of the TRI (area under the receiver operating characteristic curve: z = 1.313 and z = 0.882, respectively) for predicting in-hospital complications. CONCLUSIONS: The age SI and age MSI appear to be similar to the TRI for predicting in-hospital complications in patients with STEMI undergoing primary PCI.
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Wang et al. (2021) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI (n=257). Age shock index (age SI) and age modified shock index (age MSI) vs. Thrombolysis In Myocardial Infarction risk index (TRI) was evaluated on In-hospital complications (including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia). The age shock index and age modified shock index had comparable predictive value to the TRI for predicting in-hospital complications in STEMI patients (AUC comparison z=1.313 and z=0.882).
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