Key result
Baseline SvO2 <53% linked to ~2.4-fold higher 30-day mortality in AMI cardiogenic shock.
Why the study?
Early risk stratification of cardiogenic shock due to acute myocardial infarction remains challenging because SCAI staging is primarily based on clinical presentation and does not fully assess early physiological hemodynamic derangements. Hemodynamic parameters and oxygen transport indices may help assess short-term mortality risk within the same SCAI stage.
Does baseline mixed venous oxygen saturation (SvO₂ <53%) measured via early pulmonary artery catheterization stratify 30-day all-cause mortality risk in patients with advanced cardiogenic shock (SCAI stages D and E) secondary to acute myocardial infarction?
Cohort (n=84)
No
Does baseline mixed venous oxygen saturation (SvO₂ <53%) measured via early pulmonary artery catheterization stratify 30-day all-cause mortality risk in patients with advanced cardiogenic shock (SCAI stages D and E) secondary to acute myocardial infarction?
In patients with advanced AMI-related cardiogenic shock (SCAI stages D and E), an early pulmonary artery catheter-derived SvO₂ <53% independently predicts higher 30-day mortality and provides additional risk stratification within the same clinical SCAI stage.
Answers are grounded in this paper and cite their sources.
SvO₂ <53% may refine mortality risk stratification within SCAI stages in AMI cardiogenic shock; leaves open prospective validation before clinical adoption.
Background Early risk stratification of patients with cardiogenic shock due to acute myocardial infarction remains challenging. Although SCAI staging has been widely adopted, this system is primarily based on clinical presentation and does not fully assess early physiological hemodynamic derangements1. Hemodynamic parameters and indices related to oxygen transport and utilization may help assess short-term mortality risk among patients with cardiogenic shock within the same SCAI stage. Objectives To evaluate the role of mixed venous oxygen saturation (SvO₂) and hemodynamic parameters in combination with SCAI staging, stratifying 30-day mortality risk in patients with cardiogenic shock due to acute myocardial infarction. Methods This study presents an analysis of baseline data from 84 patients with cardiogenic shock due to acute myocardial infarction, selected from a larger study registered on ClinicalTrials.gov (NCT07062744). Hemodynamic parameters and indices of oxygen delivery–consumption were collected immediately after insertion of the pulmonary artery catheter (T0). The SCAI stage was determined at the same time point. The primary outcome was all-cause mortality within 30 days. This baseline analysis was prespecified in the registered protocol before outcome assessment. Results Thirty-day mortality in the overall study population was 32.1% (27/84). Baseline SvO₂ demonstrated the strongest ability to discriminate 30-day mortality risk (AUC 0.699; p=0.003). Mortality was higher in patients with SvO₂ <53% compared with those with SvO₂ ≥53% (54.8% vs 18.9%; p=0.0014). Within the same SCAI stage, SvO₂ enabled mortality risk classification using a threshold of 53%. The group with the highest mortality was SCAI stage E with SvO₂ <53%. Conclusions Mixed venous oxygen saturation (SvO₂) with a threshold of 53% enables stratification of 30-day mortality risk in patients with cardiogenic shock within the same SCAI stage.
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Xuân et al. (2026) conducted a cohort in Cardiogenic shock due to acute myocardial infarction (SCAI stages D and E) (n=84). Baseline mixed venous oxygen saturation (SvO₂) < 53% vs. Baseline mixed venous oxygen saturation (SvO₂) ≥ 53% was evaluated on 30-day all-cause mortality (HR 2.38, 95% CI 1.08–5.24, p=0.031). Baseline mixed venous oxygen saturation <53% was independently associated with higher 30-day mortality (HR 2.38, 95% CI 1.08–5.24, p=0.031) in advanced AMI-related cardiogenic shock.
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