1. IABP-SHOCK II Score Stratifies Patient Risk in CS after AMI
Early risk stratification for patients with cardiogenic shock (CS) is imperative for guiding treatment course and reducing mortality.
Predictors for 30-day mortality include: Age >73 years, prior stroke, glucose at admission >10.6 mmol/l (191 mg/dl), creatinine at admission >132.6 μmol/l (1.5 mg/dl), Thrombolysis In Myocardial Infarction flow grade <3 after percutaneous coronary intervention, and arterial blood lactate at admission >5 mmol/l.
This substudy of the IABP-SHOCK II trial sought to develop an easy-to-use, readily available risk prediction score for short-term mortality in patients with AMI-related CS undergoing PCI.
The observed 30-day mortality rates were 23.8% (low risk score), 49.2% (intermediate risk score), and 76.6% (high risk score).
External validation in the CardShock trial population (n = 137) showed short-term mortality rates of 28.0% (low risk score), 42.9% (intermediate risk score), and 77.3% (high risk score).
Kaplan-Meier analysis revealed a stepwise increase in mortality between the different score categories (low vs intermediate: p = 0.04; low vs high: p = 0.008).
The IABP-SHOCK II risk score, which is correlated with mortality in patients with infarct-related CS, may help stratify patient risk for short-term mortality and might facilitate clinical decision making.
Pöss J et al. J Am Coll Cardiol. 2017;69(15):
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