Key result
Cardiogenic shock complicates approximately 10% of STEMI cases with a 50% 30-day mortality, highlighting the need for early risk stratification using clinical scores to prevent deterioration.
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Early risk stratification using clinical scores and the shock index may help identify STEMI patients at high risk of developing cardiogenic shock.
Cardiogenic shock (CS) is defined as persistent hypotension (systolic blood pressure <90 mmHg) secondary to myocardial dysfunction, associated with signs of organ hypoperfusion.CS may be present in 10% of patients with ST-segment elevation myocardial infarction (STEMI) and is associated with 30-day mortality of about 50%. 1 In the majority of STEMI patients, hemodynamic deterioration occurs after hospital admission, which means that there may be room for preventive measures and highlights the importance of early recognition of those most likely to evolve to CS. 2 Scores such as Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC), Thrombolysis in Myocardial Infarction (TIMI), the Global Registry of Acute Coronary Events (GRACE) and the Zwolle risk score are used to stratify patients and enable the adoption of different levels of clinical monitoring, therapeutic care and post-discharge strategies. 3,4However, the search for simpler and more accurate scores has continued.The shock index (SI) is defined as the ratio of heart rate to systolic blood pressure, and was introduced in
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António Fiarresga (2018) conducted an editorial in Cardiogenic shock in acute myocardial infarction. Cardiogenic shock complicates approximately 10% of STEMI cases with a 50% 30-day mortality, highlighting the need for early risk stratification using clinical scores to prevent deterioration.
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