Age shock index and age-modified shock index are strong predictors of outcomes in ST-segment elevation myocardial infarction patients undergoing emergency percutaneous coronary intervention

Zhou, Jian; Shan, Peiren; Xie, Qiangli; Zhou, Xiaodong; Cai, Mengxing; Xu, Tiancheng; Huang, Weijian

doi:10.1097/mca.0000000000000759

Cited by 19 publications

(43 citation statements)

References 21 publications

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“…14 However, the accuracy of the MSI for predicting major adverse cardiovascular events, death, reinfarction or heart failure in STEMI with 1 year was found to be comparable with that of the SI in a study conducted by Reinstadler et al 9 The present study showed that the MSI was an independent predictor for in-hospital complications, which is consistent with previous studies. 12 Age is widely accepted as an important predictor of outcome in patients with acute coronary syndrome. 33 Therefore, age is integrated into various risk score systems for elderly patients who are characterized by a high frequency of comorbidities and frailty.…”

Section: Discussionmentioning

confidence: 99%

“…9 The present study showed that the MSI was an independent predictor for in-hospital complications, which is consistent with previous studies. 12…”

Section: Discussionmentioning

confidence: 99%

“…6 The shock index (SI), which is defined as the ratio of HR to systolic blood pressure, is used to predict mortality in patients with STEMI. [7][8][9][10][11][12] More recently, some derivatives of the SI, including the modified shock index (MSI), which is the ratio of HR to mean arterial pressure (MAP), the age SI (age Â the SI) and the age MSI (age Â the MSI) are used to predict an adverse prognosis in patients with STEMI. [11][12][13][14] All of these risk indices are composed of HR, age, and a parameter of blood pressure (SBP or MAP).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Wang

Liu

et al. 2021

J Int Med Res

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Objective We aimed to determine whether the prognostic value of the shock index (SI) and its derivatives is better than that of the Thrombolysis In Myocardial Infarction risk index (TRI) for predicting adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A total of 257 patients with STEMI undergoing primary PCI from January 2018 to June 2019 were analyzed in a retrospective cohort study. The SI, modified shock index (MSI), age SI (age × the SI), age MSI (age × the MSI), and TRI at admission were calculated. Clinical endpoints were in-hospital complications, including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia. Results Multivariate analyses showed that a high SI, MSI, age SI, age MSI, and TRI at admission were associated with a significantly higher rate of in-hospital complications. The predictive value of the age SI and age MSI was comparable with that of the TRI (area under the receiver operating characteristic curve: z = 1.313 and z = 0.882, respectively) for predicting in-hospital complications. Conclusions The age SI and age MSI appear to be similar to the TRI for predicting in-hospital complications in patients with STEMI undergoing primary PCI.

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Section: Discussionmentioning

confidence: 99%

“…9 The present study showed that the MSI was an independent predictor for in-hospital complications, which is consistent with previous studies. 12…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Wang

Liu

et al. 2021

J Int Med Res

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“…The age SI was calculated as the patient's age multiplied by their SI value, which was defined as the ratio of heart rate to systolic blood pressure at admission. 2,3 In this study, we calculated the admission SI value using the first set of documented vital signs upon admission to the coronary care unit or emergency department. Patients were dichotomized based on a previous report 4 into groups with a low age SI value (<41) or a high age SI value (≥41).…”

Section: Study Populationmentioning

confidence: 99%

“…1,2 Moreover, several studies have demonstrated that, relative to the original SI, the age SI (age multiplied by the admission SI) is a stronger predictor of in-hospital cardiovascular events, 6-month mortality, and long-term mortality among patients with ST-segment elevation myocardial infarction (STEMI). 3,4 However, the pathophysiological mechanisms underlying the association between the age SI and adverse outcomes among STEMI patients are unclear.…”

Section: Introductionmentioning

confidence: 99%

Association of the age shock index with coronary plaque characteristics in ST‐segment elevation myocardial infarction: A 3‐vessel optical coherence tomography study

Zhao

et al. 2021

Cathet Cardio Intervent

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Objectives: We investigated whether the age shock index (SI) was associated with coronary plaque characteristics in patients with ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT). Background:The age SI is a simple clinical parameter that effectively predicts poor clinical outcomes among patients with STEMI. Methods: This retrospective study evaluated 408 STEMI patients who underwent 3-vessel OCT during emergency percutaneous coronary interventions at a single center between January 2017 and October 2018. Patients were divided into groups with low or high age SI values (<41 vs. ≥41). Plaque characteristics were compared between the two groups for both culprit lesions (n = 408) and non-culprit lesions (n = 1,077).Results: In culprit lesions, patients with a high age SI (≥41) were more likely to have plaque rupture (61.0% vs. 56.8%, p = .002) and thinner fibrous caps (fibrous cap thickness [FCT]: 40.0 [33.0-53.0] μm vs. 46.0 [36.0-63.8] μm, p = .021). In nonculprit lesions, patients with a high age SI were more likely to have high-risk plaques (29.9% vs. 17.8%, p = .018; simultaneous presence of a minimal lumen area of <3.5 mm 2 , maximum lipid arc of >180 , FCT of <75 μm, and macrophage accumulation). Plaque-based analyses revealed that patients with a high age SI had larger lipid cores and lesser FCT.Conclusions: Patients with STEMI and a high age SI had increased risks of culprit plaque rupture and high-risk non-culprit plaques, and vulnerable plaque features at the culprit and non-culprit lesions. Therefore, a high age SI in patients with STEMI may indicate greater pancoronary vulnerability.

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Ability of a novel shock index that incorporates invasive hemodynamics to predict mortality in patients with ST‐elevation myocardial infarction

McKenzie

Zhou

Svendsen

et al. 2021

Cathet Cardio Intervent

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Objective: To determine whether the use of invasively measured hemodynamics improves the prognostic ability of a shock index (SI).Background: SI such as Admission-SI, Age-SI, Modified SI (MSI), and Age-MSI predict short-term mortality in ST-elevation myocardial infarction (STEMI).Methods: Single-center study of 510 patients who underwent primary percutaneous coronary intervention. STEMI SI was defined as age × heart rate (HR) divided by coronary perfusion pressure (CPP). Results:The mean age was 62 ± 14 years, 66% were males with hypertension (69%), tobacco use (38%), diabetes (28%) and chronic kidney disease (6%). The mean HR, systolic blood pressure (SBP), and CPP were 81 ± 18 bpm, 124 ± 28 mmHg, and 52.8 ± 16.3 mmHg, respectively. Patients with STEMI SI ≥182 (n = 51) were more likely to experience a cardiac arrest in the catheterization laboratory (9.8% vs. 2.0%; p = .001), require mechanical circulatory support (47.1% vs. 8.5%; p < .0001) and be treated with vasopressors (56.9% vs. 10.7%; p < .0001) compared to STEMI SI < 182 (n = 459). After multivariate adjustment, patients with STEMI SI ≥182 were 10, 10.1 and 4.8 times more likely to die during hospitalization, at 30 days and at 5 years, respectively. The C statistic of STEMI SI was 0.870, similar to GRACE score (AUC = 0.902; p = .29) and TIMI STEMI score (AUC = 0.895; p = .36).Conclusion: STEMI SI is an easy to calculate risk score that identifies STEMI patients at high risk of in-hospital death.

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Age shock index and age-modified shock index are strong predictors of outcomes in ST-segment elevation myocardial infarction patients undergoing emergency percutaneous coronary intervention

Cited by 19 publications

References 21 publications

Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Association of the age shock index with coronary plaque characteristics in ST‐segment elevation myocardial infarction: A 3‐vessel optical coherence tomography study

Ability of a novel shock index that incorporates invasive hemodynamics to predict mortality in patients with ST‐elevation myocardial infarction

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