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- Document type:
- Article; Journal Article
- Author(s):
- Ndrepepa, Gjin; Cassese, Salvatore; Xhepa, Erion; Fusaro, Massimiliano; Laugwitz, Karl-Ludwig; Schunkert, Heribert; Kastrati, Adnan
- Title:
- Association of shock index with short-term and long-term prognosis after ST-segment elevation myocardial infarction.
- Abstract:
- BACKGROUND: The association of shock index with long-term mortality after ST-segment elevation myocardial infarction (STEMI) remains poorly investigated. We aimed to assess the association between shock index and eight-year mortality after STEMI. METHODS: The study included 1369 patients with STEMI undergoing primary percutaneous coronary intervention (PPCI). Patients were categorized into three groups: a group with shock index in the first tertile (shock index, 0.21 to 0.52; n = 458), a group with shock index in the second tertile (shock index > 0.52 to 0.67; n = 457) and a group with shock index in the third tertile (shock index > 0.67 to 2.80; n = 454). The primary outcome was eight-year mortality. RESULTS: In patients with shock index in the first to third tertiles, inhospital cardiogenic shock (n = 153) occurred in 3.5, 3.9 and 26.2% of patients, respectively [adjusted odds ratio = 1.54, 95% confidence interval (CI) 1.40 to 1.69, P < 0.001]; 30-day deaths (n = 122) occurred in 2.8, 5.5 and 18.5% of patients, respectively [adjusted hazard ratio = 1.06 (1.01-1.12); P = 0.024]; eight-year deaths (n = 300) occurred in 22.9, 21.6 and 36.1% of patients, respectively [adjusted hazard ratio = 1.06 (1.02-1.11); P = 0.007] with all risk estimates calculated per 0.1 unit increment in shock index values. From 30 days to 8 years, deaths (n = 178) occurred in 20.7, 17.0 and 21.5% of patients in the first to third shock index tertiles, respectively (the difference was nonsignificant for all intertertile comparisons). CONCLUSIONS: In patients with STEMI, elevated shock index is associated with the risk of inhospital cardiogenic shock and mortality up to 8 years after PPCI. The long-term adverse prognosis was almost entirely driven by events within the first 30 days.
- Journal title abbreviation:
- Coron Artery Dis
- Year:
- 2019
- Journal volume:
- 30
- Journal issue:
- 8
- Pages contribution:
- 575-583
- Fulltext / DOI:
- doi:10.1097/MCA.0000000000000802
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/31577621
- Print-ISSN:
- 0954-6928
- TUM Institution:
- I. Medizinische Klinik und Poliklinik (Kardiologie); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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