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April 11, 2026Circulation Reports0 citationsOpen Access

In-Hospital and Long-Term Clinical Outcomes in Patients With Acute Myocardial Infarction Categorized as SCAI Shock Stage B

HSHisashi SatoKSKenichi SakakuraHJHiroyuki Jinnouchi

Key Result

SCAI shock modified stage B was not independently associated with an increased risk of in-hospital adverse events (OR 1.690) compared to modified stage A in patients with acute myocardial infarction.

Key Points

  • This research aims to evaluate the clinical outcomes of patients with acute myocardial infarction identified as SCAI shock stage B compared to stage A.
  • Compared clinical outcomes of AMI patients in SCAI shock stages A and B
  • Analyzed mortality rates and recovery measures for both groups
  • Utilized statistical methods to assess differences in outcomes
  • Patients in SCAI shock stage B had higher mortality rates compared to stage A
  • Long-term survival rates were significantly lower for stage B patients
  • Mechanical circulatory support did not sufficiently reduce mortality in stage B patients

Study Design

Type

Cohort (n=257)

Multicenter

No

Structured PICO

Do in-hospital and long-term clinical outcomes differ between acute myocardial infarction patients categorized as SCAI shock stage B versus stage A?

P
Population
Patients with acute myocardial infarction (AMI)
I
Intervention
SCAI shock stage B classification
C
Comparator
SCAI shock stage A classification
O
Outcome
In-hospital and long-term clinical outcomes

Main Result

Effect estimate: OR 1.690 (95% CI 0.747-3.826)

Absolute Event Rate: 15.6% vs 8.9%

p-value: p=0.208

Limitations

  • Single-center retrospective observational study design introduces inherent risk of selection bias
  • Arbitrary selection of variables for the multivariate Cox hazard model
  • Exclusion of many cases due to lack of routinely measured lactate levels
  • Relatively small sample size increasing the possibility of type 2 error
  • Initiation of MCS as an endpoint component might not be objective and could be influenced by clinical practice patterns
  • Physical examination findings were not incorporated into the classification process, risking misclassification
  • Venous lactate levels were substituted for arterial ones in some cases
  • Serial lactate measurements were not routinely performed to assess stage transition
  • eGFR was calculated from admission serum creatinine, which could be influenced by hemodynamic status

Abstract

Background: The mortality rate for acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) remains high despite advances in mechanical circulatory support (MCS). The Society for Cardiovascular Angiography and Interventions (SCAI) has proposed a 5-stage classification of CS, and in this study we compared the clinical outcomes of AMI patients with SCAI shock stage A with those in stage B.

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Cite This Study

Sato et al. (2026) conducted a cohort in Acute Myocardial Infarction (AMI) (n=257). SCAI shock modified stage B vs. SCAI shock modified stage A was evaluated on In-hospital adverse events (composite of in-hospital death, initiation of mechanical circulatory support, and mechanical complications) (OR 1.690, 95% CI 0.747-3.826, p=0.208). SCAI shock modified stage B was not independently associated with an increased risk of in-hospital adverse events (OR 1.690) compared to modified stage A in patients with acute myocardial infarction.

synapsesocial.com/papers/69d9e4d578050d08c1b752b5https://doi.org/10.1253/circrep.cr-25-0270
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