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ST YÜKSEKLİĞİ OLMAYAN MİYOKARD ENFARKTÜSÜ OLAN HASTALARDA GRACE SKORU YERİNE YAŞ-MODİFİYE ŞOK İNDEKSİ

Yıl 2023, Cilt: 4 Sayı: 2, 102 - 106, 28.07.2023
https://doi.org/10.48176/esmj.2023.114

Öz

Giriş: Kan basıncı ve kalp hızı ile bu parametrelerden türetilen şok indeksi ve modifiye şok indeksi, akut miyokard enfarktüsü geçiren hastalarda olumsuz sonuçları tahmin etmek için kapsamlı bir şekilde incelenmiştir. Yaş şok indeksi ve yaşa göre modifiye edilmiş şok indeksi, kan basıncını ve kalp atış hızını hesaplamalarına dahil eden ve böylece akut miyokard enfarktüsü hastalarında tek başına her bir kalp atış hızının ve kan basıncının öngörü değerini iyileştiren iki yeni ortaya çıkan parametredir.
Amaç: NSTEMI ile başvuran hastalarda kalp hızının ortalama arter basıncına oranının yaş-modifiye şok indeksinin (Age MSI) kullanımı zor GRACE skoruna tercih edilip edilemeyeceğini değerlendirmeyi amaçladık.
Yöntemler: Bu retrospektif çalışma, Temmuz 2019 ile Aralık 2022 tarihleri arasında, başvuru sırasında kardiyojenik şokta olmayan NSTEMI tanısı alan 495 hastayı içeren tek bir merkezde gerçekleştirildi.
Bulgular: GRACE skoru ile başvuru age MSI arasında çok iyi bir korelasyon bulundu (r: 0,752, p<0,001; AUC:0,865, p<0,001 GA %95: 0,831-0,901, cutoff : 51,0, Sensitivity %88, Spesifisite %89).
Sonuçlar: Tek başına age-MSI, PCI uygulanan NSTEMI hastalarında yüksek GRACE skoru olan hastaları belirleyebilir. Ayrıca yüksek GRACE skorlu hastaları öngörmede SI, MSI ve Age SI'dan daha iyidir. Ayrıca, Age MSI'ın hesaplanması GRACE skorundan daha kolaydır.

Kaynakça

  • 1. Raman MM. Determinants of cardiovascular disease and sequential decision-making for treatment among women: A Heckman's approach. SSM Popul Health 2019; 7: 100365.
  • 2. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction European Heart Journal 2019; 40: 237-9.
  • 3. Wang G, Wang R, Liu L, Wang J, Zhou L. Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. Journal of International Medical Research 2021; 49: 03000605211000506.
  • 4. Shuvy M, Beeri G, Klein E, et al. Accuracy of the global registry of acute coronary events (GRACE) risk score in contemporary treatment of patients with acute coronary syndrome. Canadian Journal of Cardiology 2018; 34: 1613-7.
  • 5. Haider A, Bengs S, Luu J, et al. Sex and gender in cardiovascular medicine: presentation and outcomes of acute coronary syndrome. European heart journal 2020; 41: 1328-36.
  • 6. Bordejevic DA, Caruntu F, Mornos C, et al. Prognostic impact of blood pressure and heart rate at admission on in-hospital mortality after primary percutaneous intervention for acute myocardial infarction with ST-segment elevation in western Romania. Ther. Clin. Risk Manag 2017; 13: 1061–8. 7. Timóteo AT, Toste A, Ramos R, et al. Admission heart rate as a predictor of mortality in patients with acute coronary syndromes. Acute Card. Care 2011; 13: 205–10. 8. Vassallo J, Horne S, Ball S, Smith JE. Usefulness of the Shock Index as a secondary triage tool. Journal of the Royal Army Medical Corps 2015; 161: 53-7.
  • 9. Bilkova D, Motovska Z, Widimsky P, et al. Shock index: a simple clinical parameter for quick mortality risk assessment in acute myocardial infarction. Can. J. Cardiol 2011; 27: 739–42.
  • 10. Huang B, Yang Y, Zhu J, et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction. Am. J. Cardiol 2014; 114: 1315–21.
  • 11. Spyridopoulos I, Noman A, Ahmed JM, et al. Shock-index as a novel predictor of long-term outcome following primary percutaneous coronary intervention. Eur. Heart J. Acute Cardiovasc. Care 2015; 4: 270–7.
  • 12. Abe N, Miura T, Miyashita Y, et al. Long-Term Prognostic Implications of the Admission Shock Index in Patients With Acute Myocardial Infarction Who Received Percutaneous Coronary Intervention. Angiology 2017; 68: 339–45.
  • 13. Abreu G, Azevedo P, Galvão BC, et al. Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation. Rev. Port. Cardiol. (Engl Ed). 2018; 37: 481–8.
  • 14. Hemradj VV, Ottervanger JP, de Boer MJ, et al. Zwolle Myocardial Infarction Study Group. Shock Index More Sensitive Than Cardiogenic Shock in ST-Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention. Circ. J 2017; 81: 199–205.
  • 15. Liu YC, Liu JH, Fang ZA, et al. Modified shock index and mortality rate of emergency patients. World journal of emergency medicine 2012; 3:114.
  • 16. Zarzaur BL, Croce MA, Fischer PE, Magnotti LJ, Fabian TC. New vitals after injury: shock index for the young and age x shock index for the old. J Surg Res 2008; 147:229–36. 17. Yu TT, Tian CY, Song J, He DX, Sun ZJ, Sun ZQ. Age shock index is superior to shock index and modified shock index for predicting long-term prognosis in acute myocardial infarction. Shock 2017; 48:545–50.
  • 18. Zhou J, Shan PR, Xie QL, et al. Age shock index and age-modified shock index are strong predictors of outcomes in ST-segment elevation myocardial infarction patients undergoing emergency percutaneous coronary intervention. Coronary artery disease 2019; 30: 398-405.
  • 19. Neumann F-J, Kastrati A, Pogatsa-Murray G, et al. Evaluation of prolonged antithrombotic pretreatment (“cooling-off” strategy) before intervention in patients with unstable coronary syndromes: a randomized controlled trial. JAMA 2003; 290: 1593–9.
  • 20. Bangalore S, Messerli FH, Ou FS, et al. For the CRUSADE Investigators. The association of admission heart rate and in-hospital cardiovascular events in patients with non-ST-segment elevation acute coronary syndromes: results from 135 164 patients in the CRUSADE Quality Improvement Initiative. Eur Heart J 2010; 31: 552–60.
  • 21. Torabi M, Moeinaddini S, Mirafzal A, Rastegari A, Sadeghkhani N. Shock index, modified shock index, and age shock index for prediction of mortality in Emergency Severity Index level 3. Am J Emerg Med 2016; 34: 2079–83.
  • 22. Singh A, Ali S, Agarwal A, Srivastava RN. Correlation of shock index and modified shock index with the outcome of adult trauma patients: a prospective study of 9860 patients. N Am J Med Sci 2014; 6: 450–2.
  • 23. Tang EW, Wong CK, Herbison P. Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. Am Heart J 2007; 153: 29–35.
  • 24. Aragam KG, Tamhane UU, Kline-Rogers E, et al. Does simplicity compromise accuracy in ACS risk prediction? A retrospective analysis of the TIMI and GRACE risk scores. PLoS One 2009; 4: 7947. 25. D’Ascenzo F, Biondi-Zoccai G, Moretti C, et al. TIMI, GRACE and alternative risk scores in Acute Coronary Syndromes: a meta-analysis of 40 derivation studies on 216,552 patients and of 42 validation studies on 31,625 patients. Contemp Clin Trials 2012; 33: 507–14.
  • 26. Lopes RD, Pieper KS, Horton JR, et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart 2008; 94: 867–73.

AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION

Yıl 2023, Cilt: 4 Sayı: 2, 102 - 106, 28.07.2023
https://doi.org/10.48176/esmj.2023.114

Öz

Background: Blood pressure and heart rate, as well as the shock index and modified shock index derived from these parameters, have been extensively studied to predict adverse outcomes in patients suffering from acute myocardial infarction.Age shock index and age modified shock index are two new emerging parameters that incorporate blood pressure and heart rate into their calculations, thereby improving the predictive value of each heart rate and blood pressure alone in acute myocardial infarction patients.
Objective: We aimed to asses whether the age-modified shock index (Age MSI), the ratio of heart rate to mean arterial pressure, could be preferred over the difficult-to-use GRACE score in patients presenting with NSTEMI.
Methods: This retrospective study was performed in a single center including 495 patients diagnosed with NSTEMI, without cardiogenic shock on admission, between July 2019 and December 2022.
Results: A very good correlation was found between the GRACE score and the admission age MSI (r: 0.752, p<0.001; AUC:0.865, p<0.001 CI 95%: 0.831-0.901, cutoff : 51.0, Sensitivity 88%, Specificity 89%).
Conclusions: Age MSI alone could identify patients with a high GRACE score in NSTEMI patients undergoing PCI. In addition, it is better than SI, MSI, and Age SI at predicting patients with high GRACE scores. However, Age MSI is easier to calculate than GRACE

Kaynakça

  • 1. Raman MM. Determinants of cardiovascular disease and sequential decision-making for treatment among women: A Heckman's approach. SSM Popul Health 2019; 7: 100365.
  • 2. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction European Heart Journal 2019; 40: 237-9.
  • 3. Wang G, Wang R, Liu L, Wang J, Zhou L. Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. Journal of International Medical Research 2021; 49: 03000605211000506.
  • 4. Shuvy M, Beeri G, Klein E, et al. Accuracy of the global registry of acute coronary events (GRACE) risk score in contemporary treatment of patients with acute coronary syndrome. Canadian Journal of Cardiology 2018; 34: 1613-7.
  • 5. Haider A, Bengs S, Luu J, et al. Sex and gender in cardiovascular medicine: presentation and outcomes of acute coronary syndrome. European heart journal 2020; 41: 1328-36.
  • 6. Bordejevic DA, Caruntu F, Mornos C, et al. Prognostic impact of blood pressure and heart rate at admission on in-hospital mortality after primary percutaneous intervention for acute myocardial infarction with ST-segment elevation in western Romania. Ther. Clin. Risk Manag 2017; 13: 1061–8. 7. Timóteo AT, Toste A, Ramos R, et al. Admission heart rate as a predictor of mortality in patients with acute coronary syndromes. Acute Card. Care 2011; 13: 205–10. 8. Vassallo J, Horne S, Ball S, Smith JE. Usefulness of the Shock Index as a secondary triage tool. Journal of the Royal Army Medical Corps 2015; 161: 53-7.
  • 9. Bilkova D, Motovska Z, Widimsky P, et al. Shock index: a simple clinical parameter for quick mortality risk assessment in acute myocardial infarction. Can. J. Cardiol 2011; 27: 739–42.
  • 10. Huang B, Yang Y, Zhu J, et al. Usefulness of the admission shock index for predicting short-term outcomes in patients with ST-segment elevation myocardial infarction. Am. J. Cardiol 2014; 114: 1315–21.
  • 11. Spyridopoulos I, Noman A, Ahmed JM, et al. Shock-index as a novel predictor of long-term outcome following primary percutaneous coronary intervention. Eur. Heart J. Acute Cardiovasc. Care 2015; 4: 270–7.
  • 12. Abe N, Miura T, Miyashita Y, et al. Long-Term Prognostic Implications of the Admission Shock Index in Patients With Acute Myocardial Infarction Who Received Percutaneous Coronary Intervention. Angiology 2017; 68: 339–45.
  • 13. Abreu G, Azevedo P, Galvão BC, et al. Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation. Rev. Port. Cardiol. (Engl Ed). 2018; 37: 481–8.
  • 14. Hemradj VV, Ottervanger JP, de Boer MJ, et al. Zwolle Myocardial Infarction Study Group. Shock Index More Sensitive Than Cardiogenic Shock in ST-Elevation Myocardial Infarction Treated by Primary Percutaneous Coronary Intervention. Circ. J 2017; 81: 199–205.
  • 15. Liu YC, Liu JH, Fang ZA, et al. Modified shock index and mortality rate of emergency patients. World journal of emergency medicine 2012; 3:114.
  • 16. Zarzaur BL, Croce MA, Fischer PE, Magnotti LJ, Fabian TC. New vitals after injury: shock index for the young and age x shock index for the old. J Surg Res 2008; 147:229–36. 17. Yu TT, Tian CY, Song J, He DX, Sun ZJ, Sun ZQ. Age shock index is superior to shock index and modified shock index for predicting long-term prognosis in acute myocardial infarction. Shock 2017; 48:545–50.
  • 18. Zhou J, Shan PR, Xie QL, et al. Age shock index and age-modified shock index are strong predictors of outcomes in ST-segment elevation myocardial infarction patients undergoing emergency percutaneous coronary intervention. Coronary artery disease 2019; 30: 398-405.
  • 19. Neumann F-J, Kastrati A, Pogatsa-Murray G, et al. Evaluation of prolonged antithrombotic pretreatment (“cooling-off” strategy) before intervention in patients with unstable coronary syndromes: a randomized controlled trial. JAMA 2003; 290: 1593–9.
  • 20. Bangalore S, Messerli FH, Ou FS, et al. For the CRUSADE Investigators. The association of admission heart rate and in-hospital cardiovascular events in patients with non-ST-segment elevation acute coronary syndromes: results from 135 164 patients in the CRUSADE Quality Improvement Initiative. Eur Heart J 2010; 31: 552–60.
  • 21. Torabi M, Moeinaddini S, Mirafzal A, Rastegari A, Sadeghkhani N. Shock index, modified shock index, and age shock index for prediction of mortality in Emergency Severity Index level 3. Am J Emerg Med 2016; 34: 2079–83.
  • 22. Singh A, Ali S, Agarwal A, Srivastava RN. Correlation of shock index and modified shock index with the outcome of adult trauma patients: a prospective study of 9860 patients. N Am J Med Sci 2014; 6: 450–2.
  • 23. Tang EW, Wong CK, Herbison P. Global Registry of Acute Coronary Events (GRACE) hospital discharge risk score accurately predicts long-term mortality post acute coronary syndrome. Am Heart J 2007; 153: 29–35.
  • 24. Aragam KG, Tamhane UU, Kline-Rogers E, et al. Does simplicity compromise accuracy in ACS risk prediction? A retrospective analysis of the TIMI and GRACE risk scores. PLoS One 2009; 4: 7947. 25. D’Ascenzo F, Biondi-Zoccai G, Moretti C, et al. TIMI, GRACE and alternative risk scores in Acute Coronary Syndromes: a meta-analysis of 40 derivation studies on 216,552 patients and of 42 validation studies on 31,625 patients. Contemp Clin Trials 2012; 33: 507–14.
  • 26. Lopes RD, Pieper KS, Horton JR, et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart 2008; 94: 867–73.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kardiyoloji , Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Mert Evlıce 0000-0003-4733-6348

Erken Görünüm Tarihi 28 Temmuz 2023
Yayımlanma Tarihi 28 Temmuz 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 4 Sayı: 2

Kaynak Göster

APA Evlıce, M. (2023). AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION. Eskisehir Medical Journal, 4(2), 102-106. https://doi.org/10.48176/esmj.2023.114
AMA Evlıce M. AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION. Eskisehir Med J. Temmuz 2023;4(2):102-106. doi:10.48176/esmj.2023.114
Chicago Evlıce, Mert. “AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION”. Eskisehir Medical Journal 4, sy. 2 (Temmuz 2023): 102-6. https://doi.org/10.48176/esmj.2023.114.
EndNote Evlıce M (01 Temmuz 2023) AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION. Eskisehir Medical Journal 4 2 102–106.
IEEE M. Evlıce, “AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION”, Eskisehir Med J, c. 4, sy. 2, ss. 102–106, 2023, doi: 10.48176/esmj.2023.114.
ISNAD Evlıce, Mert. “AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION”. Eskisehir Medical Journal 4/2 (Temmuz 2023), 102-106. https://doi.org/10.48176/esmj.2023.114.
JAMA Evlıce M. AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION. Eskisehir Med J. 2023;4:102–106.
MLA Evlıce, Mert. “AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION”. Eskisehir Medical Journal, c. 4, sy. 2, 2023, ss. 102-6, doi:10.48176/esmj.2023.114.
Vancouver Evlıce M. AGE MODIFIED SHOCK INDEX INSTEAD OF GRACE SCORE IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION. Eskisehir Med J. 2023;4(2):102-6.