Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation

Abreu, Glória; Azevedo, Pedro; Braga, Carlos Galvão; Vieira, Catarina; Pereira, Mauro; Martins, Juliana; Arantes, Carina; Rodrigues, Cristina S.; Salgado, Alberto; Marques, Jorge

doi:10.1016/j.repc.2017.07.018

Cited by 23 publications

(20 citation statements)

References 13 publications

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“…They divided the patients into two groups based on the modified shock index MSI at presentation and retrospectively followed them for 6 months. They reported that there was a significant difference among their studied groups regarding serum troponin level [21].…”

Section: Discussionmentioning

confidence: 93%

Relation between Shock Index, Severity of Coronary Artery Disease and Outcomes in ST Elevation Myocardial Infarction Patients

Sharban

Alaarag

Elsaidy

et al. 2021

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Background: Coronary artery disease is considered a major cause of death in both male and female subjects in the developed world and carries a risk of several complications. Multiple scores have been developed in order to set risk stratification and predict the outcomes for ischemic patients. Another scores have been developed in order to assess the severity of the coronary arteries lesions. Methods: The prospective cross sectional cohort study included 68 consecutive patients with STEMI; they were divided into two groups based on the shock index at presentation. Group A: included 43 patients with SI ˂0.7. Group B: included 25 patients with SI ˃ 0.7. All participants were subjected to trans-thoracic echocardiography, PPCI, SYNTAX score calculation and follow up during the hospitalization period. Results: There was a significant myocardial damage in group B supported by the reduced LVEF and elevated serum troponin at presentation. There was a significant more coronary artery lesion severity in group B as assessed by the SYNTAX score. As regard in-hospital outcomes, patients in group B had the worst outcomes during the hospitalization period. Conclusions: Shock index is a useful and quick tool to predict the severity of the underling coronary artery disease and correlate with the SYNTAX score in patients with STEMI. Shock index is a good indicator of the hemodynamics and the extent of myocardial damage. Shock index is a quick bedside tool with a good prediction value for the in-hospital outcomes in STEMI patients undergoing PPCI.

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Section: Discussionmentioning

confidence: 93%

Relation between Shock Index, Severity of Coronary Artery Disease and Outcomes in ST Elevation Myocardial Infarction Patients

Sharban

Alaarag

Elsaidy

et al. 2021

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“…Until now, ACS has become a disease with the highest mortality rate in developed countries with an expectation to have the same status in developing countries ( 1 ). Risk assessment is, therefore, crucial for estimating a patient’s prognosis and indicating the need for a more aggressive approach when needed ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…Both the Thrombolysis in Myocardial Infarction (TIMI) and the Global Registry of Acute Coronary Events (GRACE) have been widely utilized as ACS risk scoring systems with strong predictive values ( 2 , 3 ). Compared to TIMI, the GRACE score is more accurate in predicting both short-term and long-term prognoses ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…This score is, arguably, sophisticated as it used tables for calculation and is available through applications and websites ( 1 , 6 ). However, GRACE score heavily relies on laboratory parameters and electrocardiographic (ECG) findings, hence, time-consuming, and may be difficult to perform routinely bedside ( 2 ). A simple and convenient scoring system is, therefore, needed to better assess in-hospital mortality risk in patients with ACS.…”

Section: Introductionmentioning

confidence: 99%

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Modified Shock Index as Simple Clinical Independent Predictor of In-Hospital Mortality in Acute Coronary Syndrome Patients: A Retrospective Cohort Study

Pramudyo

Marindani

Achmad

et al. 2022

Front. Cardiovasc. Med.

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IntroductionDespite being the current most accurate risk scoring system for predicting in-hospital mortality for patients with acute coronary syndrome (ACS), the Global Registry of Acute Coronary Events (GRACE) risk score is time consuming due to the requirement for electrocardiography and laboratory examinations. This study is aimed to evaluate the association between modified shock index (MSI), as a simple and convenient index, with in-hospital mortality and revascularization in hospitalized patients with ACS.MethodsA single-centered, retrospective cohort study, involving 1,393 patients with ACS aged ≥ 18 years old, was conducted between January 2018 and January 2022. Study subjects were allocated into two cohorts: high MSI ≥ 1 (n = 423) and low MSI < 1 group (n = 970). The outcome was in-hospital mortality and revascularization. The association between MSI score and interest outcomes was evaluated using binary logistic regression analysis. The area under the curve (AUC) between MSI and GRACE score was compared using De Long’s method.ResultsModified shock index ≥ 1 had 61.1% sensitivity and 73.7% specificity. A high MSI score was significantly and independently associated with in-hospital mortality in patients with ACS [odds ratio (OR) = 2.72(1.6–4.58), p < 0.001]. However, ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) patients with high MSI did not significantly increase the probability of revascularization procedures. Receiver operating characteristic (ROC) analysis demonstrated that although MSI and GRACE scores were both good predictors of in-hospital mortality with the AUC values of 0.715 (0.666–0.764) and 0.815 (0.775–0.855), respectively, MSI was still inferior as compared to GRACE scores in predicting mortality risk in patients with ACS (p < 0.001).ConclusionModified shock index, particularly with a score ≥ 1, was a useful and simple parameter for predicting in-hospital mortality in patients presenting with ACS.

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“…[7][8][9][10][11][12] More recently, some derivatives of the SI, including the modified shock index (MSI), which is the ratio of HR to mean arterial pressure (MAP), the age SI (age Â the SI) and the age MSI (age Â the MSI) are used to predict an adverse prognosis in patients with STEMI. [11][12][13][14] All of these risk indices are composed of HR, age, and a parameter of blood pressure (SBP or MAP). Whether the age SI or age MSI is comparable, or even superior, to the TRI for predicting the prognosis of patients with STEMI has not yet been determined.…”

Section: Introductionmentioning

confidence: 99%

Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Wang

Liu

et al. 2021

J Int Med Res

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Objective We aimed to determine whether the prognostic value of the shock index (SI) and its derivatives is better than that of the Thrombolysis In Myocardial Infarction risk index (TRI) for predicting adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A total of 257 patients with STEMI undergoing primary PCI from January 2018 to June 2019 were analyzed in a retrospective cohort study. The SI, modified shock index (MSI), age SI (age × the SI), age MSI (age × the MSI), and TRI at admission were calculated. Clinical endpoints were in-hospital complications, including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia. Results Multivariate analyses showed that a high SI, MSI, age SI, age MSI, and TRI at admission were associated with a significantly higher rate of in-hospital complications. The predictive value of the age SI and age MSI was comparable with that of the TRI (area under the receiver operating characteristic curve: z = 1.313 and z = 0.882, respectively) for predicting in-hospital complications. Conclusions The age SI and age MSI appear to be similar to the TRI for predicting in-hospital complications in patients with STEMI undergoing primary PCI.

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Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation

Abstract: MSI was shown to be a valuable bedside tool which can rapidly identify high-risk STEMI patients at presentation.

Cited by 23 publications

References 13 publications

Relation between Shock Index, Severity of Coronary Artery Disease and Outcomes in ST Elevation Myocardial Infarction Patients

Relation between Shock Index, Severity of Coronary Artery Disease and Outcomes in ST Elevation Myocardial Infarction Patients

Modified Shock Index as Simple Clinical Independent Predictor of In-Hospital Mortality in Acute Coronary Syndrome Patients: A Retrospective Cohort Study

Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

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