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Shock index and TIMI risk index as valuable prognostic tools in patients with acute coronary syndrome complicated by cardiogenic shock


Autoři: Karolina Supeł aff001;  Michał Kacprzak aff001;  Marzenna Zielińska aff001
Působiště autorů: Intensive Cardiac Therapy Clinic, Medical University of Lodz, Lodz, Poland aff001
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227374

Souhrn

Background

The aim of the study was to evaluate the usefulness of the shock index (SI) and the TIMI risk index (TRI Thrombolysis in Myocardial Infarction Risk Index) one hour after successful primary percutaneous coronary intervention (pPCI) for predicting in-hospital mortality in patients with acute coronary syndrome complicated by cardiogenic shock (CS).

Methods

Forty-seven consecutive patients with acute myocardial infarction (AMI) complicated by CS were included in this prospective observational study. All patients underwent pPCI and obtained TIMI Grade Flow 3. SI and TRI were calculated one hour after pPCI.

Results

The primary endpoint—death from cardiovascular causes—occurred in 17 patients (36%). All calculated parameters were significantly higher in fatal CS than in the non-fatal CS group. A multivariate logistic regression model found only TRI to be an independent, significant predictor of death in the study group, with a proposed cut-off point of 66, with sensitivity 76.5% and specificity 83.3% (AUC 0.811, p = 0.00001).

Conclusions

The simple parameters of clinical assessment—SI and TRI—calculated one hour after a successful pPCI of infarct related artery are important predictors of death in AMI complicated by cardiogenic shock.

Klíčová slova:

Arteries – Blood pressure – Coronary angioplasty – Coronary heart disease – Death rates – Heart rate – Myocardial infarction – diabetes mellitus


Zdroje

1. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). (2012). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart J 33: 2569–2619.

2. Allgower M, Burri C. Shock index. Dtsch Med Wochenschr 1967;92:1947–1950. doi: 10.1055/s-0028-1106070 5299769

3. Yussof SJ, Zakaria MI, Mohamed FL, Bujang MA, Lakshmanan S, Asaari AH. Value of Shock Index in prognosticating the short-term outcome of death for patients presenting with severe sepsis and septic shock in the emergency department. Med J Malaysia 2012;67:406–411. 23082451

4. Huang B, Yang Y, Zhu J, Liang Y, Tan H, Yu L, et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction. Am J Cardiol 2014;114:1315–21. doi: 10.1016/j.amjcard.2014.07.062 25201214

5. Morrow DA, Antman EM, Giugliano RP, Cairns R, Charlesworth A, Murphy SA, et al. A simple risk index for rapid initial triage of patients with ST-elevation myocardial infarction: an InTIME II substudy. Lancet 2001;358:1571–5. doi: 10.1016/S0140-6736(01)06649-1 11716882

6. Thygsen K, Alpert J, Jaffe A, Simoons M, Chaitman B, White H: the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Univrsal Definition of Myocardial Infarction (2012). Third universal definition of myocardial infarction. European Heart J 33: 2551–2567.

7. www.mdcalc.com

8. Bilkova D, Motovska Z, Widymsky P, Dvorak J, Lisa L, Budesinsky T. Shock index: a simple clinical parameter for quick mortality risk assessment in acute myocardial infarction. Can J Cardiol 2011;27:739–42. doi: 10.1016/j.cjca.2011.07.008 21944278

9. Spyridopoulos I, Noman A, Ahmed JM, Das R, Edwards R, Purcell I, et al. Shock-index as a novel predictor of long term outcome following primary percutaneous coronary intervention. Eur Heart J Acute Cardiovasc Care 2015;4:270–7. doi: 10.1177/2048872614561480 25425723

10. Kobayashi A, Misumida N, Luger D, Kanei Y. Shock index as a predictor for in-hospital mortality in patients with non-ST-segment elevation myocardial infarction. Cardiovasc Revasc Med. 2016, Epub ahead of print.

11. Wiviott SD, Morrow DA, Frederick PD, Antman EM, Braunwald E. Application of the Thrombolysis in Myocardial Infarction Index in non-ST-segment elevation myocardial infarction: evaluation of patients in the National Registry of Myocardial Infarction. J Am Coll Cardiol. 2006;18;47(8):1553–8. doi: 10.1016/j.jacc.2005.11.075 16630990

12. Ilkhanoff L, O’Donnell CJ, Camargo CA, O’Halloran TD, Giugliano RP, Lloyd-Jones DM. Usefulness of the TIMI risk index in predicting short- and long-term mortality in patients with acute coronary syndromes. Am J Cardiol 2005;96:773–7. doi: 10.1016/j.amjcard.2005.04.059 16169358

13. Bradshaw PJ, Ko DT, Newman AM, Donovan LR, Tu JVT. Validation of the Thrombolysis In Myocardial Infarction (TIMI) risk index for predicting early mortality in a population-based cohort of STEMI and non-STEMI patients. Can J Cardiol. 2007;23(1):51–6. doi: 10.1016/s0828-282x(07)70213-1 17245483

14. Truong QA, Cannon CP, Zakai NA, Rogers IS, Giugliano RP, Wiviott SD, et al. Thrombolysis in Myocardial Infarction (TIMI) Risk Index predicts long-term mortality and heart failure in patients with ST-elevation myocardial infarction in the TIMI 2 clinical trial. Am Heart J 2009;157(4):673–9. doi: 10.1016/j.ahj.2008.12.010 19332194


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