Higher age shock index was associated with increased all-cause mortality (HR 1.025; 95% CI 1.010-1.040; P=0.001) and showed better prognostic performance than admission SI and MSI.
Cohort (n=1,864)
Does admission age shock index predict long-term all-cause mortality better than shock index, modified shock index, and GRACE risk score in patients with acute myocardial infarction undergoing PCI?
Age shock index is a simple and effective prognostic tool, performing similarly to the more complex GRACE score and better than standard shock indices for predicting mortality in AMI patients post-PCI.
Effect estimate: HR 1.025 (95% CI 1.010-1.040)
p-value: p=0.001
BACKGROUND: Shock index (SI) has been reported to help us predict adverse prognosis in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). However, the prognostic value of age SI and modified shock index (MSI) in AMI undergoing PCI is unknown. Moreover, the prognostic performance of admission age SI is not compared with SI, MSI, and the Global Registry of Acute Coronary Events (GRACE) risk score. METHODS: One thousand eight hundred sixty-four AMI patients undergoing PCI were analyzed in a retrospective cohort study. Clinical endpoint was all-cause mortality. The predictive performance of new models was assessed by C-statistic, Hosmer-Lemeshow test, Nagelkerke-R, Brier scores, integrated discrimination improvement (IDI), and net reclassification improvement (NRI). RESULTS: Multivariate analysis showed that higher age SI and MSI were both associated with a higher rate of all-cause mortality age SI: hazard ratios (HR) = 1.025, 95% CI = 1.010-1.040, P = 0.001; MSI: HR = 2.902, 95% CI = 1.180-7.137, P = 0.020. The prognostic performance of admission age SI was similar to the GRACE systems for predicting all-cause mortality (C-statistic: z = 0.437, P = 0.662; IDI: -0.005, P = 0.474; NRI: -0.028, P = 0.257), but better than admission SI (C-statistic: z = 3.944, P < 0.001; IDI: 0.012, P = 0.016; NRI: 0.472, P < 0.001) and admission MSI (C-statistic: z = 3.214, P = 0.001; IDI: 0.011, P = 0.001; NRI: 0.561, P < 0.001). CONCLUSIONS: Age SI alone can identify patients at high risk of death in AMI patients undergoing PCI. It is similar to GRACE but better than SI and MSI for predicting all-cause mortality. However, age SI is easier to calculate than GRACE.
Yu et al. (Sat,) conducted a cohort in acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) (n=1,864). Age Shock Index (age SI) vs. Shock index (SI), modified shock index (MSI), and GRACE risk score was evaluated on all-cause mortality (HR 1.025, 95% CI 1.010-1.040, p=0.001). Higher age shock index was associated with increased all-cause mortality (HR 1.025; 95% CI 1.010-1.040; P=0.001) and showed better prognostic performance than admission SI and MSI.