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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

Zhou, Jian,*; Shan, Pei-Ren,*; Xie, Qiang-Li; Zhou, Xiao-Dong; Cai, Meng-Xing; Xu, Tian-Cheng; Huang, Wei-Jian

doi: 10.1097/MCA.0000000000000759
STEMI
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SDC

Background Early identification of high-risk patients provides clinicians with greater decision-making time and better informs strategies to cope with disease. The predictive values of age shock index (age SI) and age-modified shock index (age MSI) in ST-segment elevation myocardial infarction (STEMI) patients undergoing emergency percutaneous coronary intervention (PCI) have rarely been reported, especially compared with those for SI, MSI, and the Global Registry of Acute Coronary Events (GRACE) risk score.

Patients and methods Nine hundred and eighty-three STEMI patients undergoing emergency PCI between January 2014 and September 2017 were analyzed in a retrospective cohort study. The primary outcomes were rates of in-hospital cardiovascular events, and 6-month and long-term all-cause mortality.

Results In multivariate analyses, the predictive values of age SI and age MSI were comparable to that of the GRACE score, but superior to those of SI and MSI for in-hospital cardiac mortality [age SI: odds ratio (OR) = 1.05, P < 0.001, area under the receiver operating characteristic (ROC-AUC) = 0.805, P < 0.001; age MSI: OR = 1.04, P < 0.001, ROC-AUC = 0.813, P < 0.001; GRACE score: OR = 1.03, P < 0.001, ROC-AUC = 0.827, P < 0.001], 6-month all-cause mortality (age SI: OR = 1.04, P < 0.001, ROC-AUC = 0.791, P < 0.001; age MSI: OR = 1.03, P < 0.001, ROC-AUC = 0.801, P < 0.001; GRACE score: ROC-AUC = 0.828, P < 0.001), long-term all-cause mortality [age SI: hazard ratio (HR) = 1.06, P < 0.001, ROC-AUC = 0.798, P < 0.001; age MSI: HR = 1.04, P < 0.001, ROC-AUC = 0.84, P < 0.001; GRACE score: ROC-AUC = 0.822, P < 0.001] and post-discharge all-cause mortality (age SI: HR = 1.05, P < 0.001, ROC-AUC = 0.78, P = 0.001; age MSI: HR = 1.05, P < 0.001, ROC-AUC = 0.789, P < 0.001; GRACE score: ROC-AUC = 0.812, P < 0.001).

Conclusion Age SI and age MSI are stronger predictors than SI and MSI for in-hospital cardiovascular events, and 6-month and long-term all-cause mortality in STEMI patients undergoing emergency PCI. Age SI and age MSI appear to be convenient and simpler indicators than the GRACE score.

983 ST-segment elevation myocardial infarction (STEMI) patients undergoing emergency percutaneous coronary intervention (PCI) between January 2014 and September 2017 were analyzed in a retrospective cohort study. In multivariate analyses, the predictive values of age shock index (age SI) and age-modified shock index (age MSI) were comparable to that of the Global Registry of Acute Coronary Events (GRACE) risk score but superior to those of SI and MSI for in-hospital cardiac mortality, six-month all-cause mortality, long-term all-cause mortality and post-discharge all-cause mortality. Age SI and age MSI appear to be convenient and simpler indicators than the GRACE score.

The Key Lab of Cardiovascular Disease of Wenzhou, Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

* Jian Zhou and Pei-Ren Shan contributed equally to the writing of this article.

Received 27 October 2018 Revised 15 April 2019 Accepted 16 April 2019

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Correspondence to Wei-Jian Huang, MD, Department of Cardiovascular Medicine, The Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang, Wenzhou 325100, China, Tel: + 86 138 0669 1086; fax: + 86 577 8806 9718; e-mail: weijianhuang69@126.com

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