Abstract
The objective of this study was to examine whether shock index (SI), defined by ratio of heart rate and systolic blood pressure, can predict long-term prognosis of acute coronary syndrome (ACS) in patients undergoing percutaneous coronary intervention (PCI) and to compare prognostic accuracy of SI with the Global Registry of Acute Coronary Events (GRACE) risk score. This study included individuals from 2 independent cohorts: derivation cohort (n = 2631) and validation cohort (n = 963). In the derivation cohort, we derived that higher admission SI was associated with a greater risk of long-term all-cause mortality [HR = 4.104, 95% CI 1.553 to 10.845, p = 0.004] after adjusting for covariates. We validated this finding in the validation cohort [HR = 10.091, 95% CI 2.205 to 46.187, p = 0.003]. Moreover, admission SI had similar performance to the GRACE score in determining all-cause mortality risk in both cohorts (derivation cohort, admission SI vs. GRACE, z = 1.919, p = 0.055; validation cohort, admission SI vs. GRACE, z = 1.039, p = 0.299). In conclusion, admission SI is an independent predictor of adverse outcome in ACS patients undergoing PCI, and can identify patients at high risk of death. SI and the GRACE score showed similar performance in predicting all-cause mortality, and SI is more readily obtained than the GRACE score.
Highlights
The shock index (SI) is determined by the ratio of heart rate and systolic blood pressure, usually measured on admission and before later interventions[8–20]
In line with the previous studies, our study demonstrated that admission SI is an independent predictor of adverse outcome in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI)
We showed that admission SI has the same prognostic performance as the Global Registry of Acute Coronary Events (GRACE) score for predicting all-cause mortality in ACS patients undergoing PCI
Summary
The shock index (SI) is determined by the ratio of heart rate and systolic blood pressure, usually measured on admission and before later interventions[8–20]. The association between SI and greater in-hospital mortality risk in patients with NSTEMI has been confirmed[19], and elevated SI correlates with a poorer 5-year prognosis in patients with AMI undergoing PCI20. In most of these studies, SI values of
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