Coronary Artery DiseaseUsefulness of the Admission Shock Index for Predicting Short-Term Outcomes in Patients With ST-Segment Elevation Myocardial Infarction
Section snippets
Methods
This is a retrospective study of consecutive patients with acute STEMI within 12 hours from symptom onset from 2001 to 2004 in 247 hospitals in China. Although it is a retrospective study, data were collected prospectively. STEMI was defined as following: chest pain or equivalent symptoms in combination with dynamic electrocardiographic changes consistent with STEMI (in the presence of ST elevation >0.1 mV in ≥2 extremity leads, >0.2 mV in ≥2 precordial leads, or accompanying with left bundle
Results
Of 7,510 patients, 323 were excluded because of incomplete data or nonsinus rhythm at admission, and 7,187 remaining patients were analyzed. The best cutoff of SI for predicting 7-day all-cause mortality was 0.7 by receiver operating characteristic curve, and the sensitivity and specificity were 59.0% and 74.4%, respectively. With this threshold, 5,026 patients had normal admission SI (<0.7) and 2,161 patients had elevated admission SI (≥0.7).
Table 1 lists the baseline characteristics of the
Discussion
The main findings of this study are as follows. First, those who presented with elevated admission SI (≥0.7) had greater incidence of short-term cardiovascular events compared with those with normal admission SI (<0.7) in patients with STEMI. Second, after multivariate adjustment, elevated admission SI (≥0.7) was still an independent risk factor predicting the short-term outcomes. Third, the prognostic discriminatory capacity of admission SI is moderate for 7-day all-cause mortality but limited
Acknowledgment
The authors thank investigators from every hospital for providing data, and all the study coordinators, as well as patients who participated in the multicenter study.
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