A Risk Stratification Scheme for In-Hospital Cardiogenic Shock in Patients With Acute Myocardial Infarction

Frontiers in Cardiovascular Medicine

article

Jun-qing Yang¹  Peng Ran¹  Jie Li¹  Qi Zhong¹  Sidney C. Smith, Jr.²  Yan Wang³  Gregg C. Fonarow⁴  Jia Qiu¹  Louise Morgan⁵  Xue-biao Wei¹  Xiao-bo Chen⁶  Jie-leng Huang¹  Yong-chen Hao⁷  Ying-ling Zhou¹  Chung-Wah Siu⁸  Dong Zhao⁷  Ji-yan Chen¹  Dan-qing Yu¹ 

[1] Guangdong Provincial Key Laboratory of Coronary Heart Disease, Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences;Division of Cardiology, University of North Carolina;Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Ministry of Education;Division of Cardiology, Geffen School of Medicine at University of California;International Quality Improvement Department;Department of Pediatrics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences;Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart;Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong

关键词: acute myocardial infarction;    cardiogenic shock;    risk score;    heart rate;    heart failure;   

DOI  :  10.3389/fcvm.2022.793497

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Objective Cardiogenic shock (CS) is the leading cause of death in patients with acute myocardial infarction (AMI) despite advances in care. This study aims to derive and validate a risk score for in-hospital development of CS in patients with AMI. Methods In this study, we used the Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome (CCC–ACS) registry of 76,807 patients for model development and internal validation. These patients came from 158 tertiary hospitals and 82 secondary hospitals between 2014 and 2019, presenting AMI without CS upon admission. The eligible patients with AMI were randomly assigned to derivation ( n = 53,790) and internal validation ( n = 23,017) cohorts. Another cohort of 2,205 patients with AMI between 2014 and 2016 was used for external validation. Based on the identified predictors for in-hospital CS, a new point-based CS risk scheme, referred to as the CCC–ACS CS score, was developed and validated. Results A total of 866 (1.1%) and 39 (1.8%) patients subsequently developed in-hospital CS in the CCC–ACS project and external validation cohort, respectively. The CCC–ACS CS score consists of seven variables, including age, acute heart failure upon admission, systolic blood pressure upon admission, heart rate, initial serum creatine kinase-MB level, estimated glomerular filtration rate, and mechanical complications. The area under the curve for in-hospital development of CS was 0.73, 0.71, and 0.85 in the derivation, internal validation and external validation cohorts, respectively. Conclusion This newly developed CCC–ACS CS score can quantify the risk of in-hospital CS for patients with AMI, which may help in clinical decision making.

【 授权许可】

CC BY