Key result
A 9-variable clinical risk score accurately predicts cardiogenic shock within 72 hours of AMI.
Why the study?
Can a risk-predictive score accurately predict the occurrence of cardiogenic shock within 72 hours after admission in Chinese patients with ST-segment elevated AMI?
Observational (n=2,077)
Yes
Can a risk-predictive score accurately predict the occurrence of cardiogenic shock within 72 hours after admission in Chinese patients with ST-segment elevated AMI?
A newly developed risk score based on simple clinical parameters can accurately predict the occurrence of cardiogenic shock within 72 hours in Chinese patients with ST-segment elevated AMI.
May support early risk stratification in AMI; leaves open external validation and outcome impact.
BACKGROUND: Cardiogenic shock after acute myocardial infarction (AMI) remains a poor prognosis. Although numerous studies discussed the predictors of cardiogenic shock complicating AMI, the data in Chinese patients is still absent. The goal of this study is to develop a risk-predictive score for cardiogenic shock after AMI, among Chinese patients, so as to guide clinicians to prevent cardiogenic shock. METHODS: Patients with ST-segment elevated AMI were provided by two Chinese hospitals from 1994 to 2004. Baseline characteristics of each case were documented. Multivariable logistic regression modeling techniques were used to develop a model to predict the occurrence of cardiogenic shock within 72 h after admission. On the basis of the coefficients in the model, a risk score was developed for the probability of cardiogenic shock. To test its viability, another population, which was consistent with the original population, confirmed the scoring. RESULTS: Among 2,077 patients, 184 cases developed cardiogenic shock within 72 h. Age, gender, BMI, killip class, MI location, multivessel disease, previous MI, family history of CAD, and thrombolytic therapy were strong predictors for shock after AMI. A risk-predictive score for shock was developed. It predicted cardiogenic shock accurately in another Chinese population. CONCLUSIONS: A predictive model is developed in Chinese patients with AMI for the first time. It is based on some simple parameters, which can be easily obtained by clinicians. The risk score derived from the model can predict cardiogenic shock accurately.
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Zhang et al. (2007) conducted an observational in ST-segment elevated acute myocardial infarction (AMI) (n=2,077). Clinical predictors (age, gender, BMI, Killip class, MI location, multivessel disease, previous MI, family history of CAD, thrombolytic therapy) was evaluated on Occurrence of cardiogenic shock within 72 hours after admission. A risk-predictive score based on 9 clinical predictors accurately predicted the occurrence of cardiogenic shock, which developed in 184 of 2,077 (8.9%) Chinese patients with AMI within 72 hours.
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