Journal article
Predicting mortality in cardiogenic shock secondary to ACS requiring short-term mechanical circulatory support: The ACS-MCS score
Catheterization and cardiovascular interventions, Vol.98(7), pp.1275-1284
12/01/2021
DOI: 10.1002/ccd.29581
PMCID: PMC8421447
PMID: 33682308
Abstract
To identify predictors of 30-day all-cause mortality for patients with cardiogenic shock secondary to acute coronary syndrome (ACS-CS) who require short-term mechanical circulatory support (ST-MCS).
ACS-CS mortality is high. ST-MCS is an attractive treatment option for hemodynamic support and stabilization of deteriorating patients. Mortality prediction modeling for ACS-CS patients requiring ST-MCS has not been well-defined.
The Utah Cardiac Recovery (UCAR) Shock database was used to identify patients admitted with ACS-CS requiring ST-MCS devices between May 2008 and August 2018. Pre-ST-MCS clinical, laboratory, echocardiographic, and angiographic data were collected. The primary endpoint was 30-day all-cause mortality. A weighted score comprising of pre-ST-MCS variables independently associated with 30-day all-cause mortality was derived and internally validated.
A total of 159 patients (mean age, 61 years; 78% male) were included. Thirty-day all-cause mortality was 49%. Multivariable analysis resulted in four independent predictors of 30-day all-cause mortality: age, lactate, SCAI CS classification, and acute kidney injury. The model had good calibration and discrimination (area under the receiver operating characteristics curve 0.80). A predictive score (ranging 0-4) comprised of age ≥ 60 years, pre-ST-MCS lactate ≥2.5 mmol/L, AKI at time of ST-MCS implementation, and SCAI CS stage E effectively risk stratified our patient population.
The ACS-MCS score is a simple and practical predictive score to risk-stratify CS secondary to ACS patients based on their mortality risk. Effective mortality risk assessment for ACS-CS patients could have implications on patient selection for available therapeutic strategy options.
Details
- Title: Subtitle
- Predicting mortality in cardiogenic shock secondary to ACS requiring short-term mechanical circulatory support: The ACS-MCS score
- Creators
- Qussay Marashly - University of UtahIosif Taleb - University of UtahChristos P Kyriakopoulos - University of UtahElizabeth Dranow - University of UtahTara L Jones - University of UtahAnwar Tandar - University of UtahSean D Overton - University of UtahJoseph E Tonna - University of UtahKathleen Stoddard - University of UtahOmar Wever-Pinzon - University of UtahLine Kemeyou - University of UtahAntigone G Koliopoulou - University of UtahKevin S Shah - University of UtahKimiya Nourian - University of UtahTyler J Richins - University of UtahTyson S Burnham - University of UtahFrederick G Welt - University of UtahStephen H McKellar - University of UtahJose Nativi-Nicolau - University of UtahStavros G Drakos - University of Utah
- Resource Type
- Journal article
- Publication Details
- Catheterization and cardiovascular interventions, Vol.98(7), pp.1275-1284
- DOI
- 10.1002/ccd.29581
- PMID
- 33682308
- PMCID
- PMC8421447
- NLM abbreviation
- Catheter Cardiovasc Interv
- ISSN
- 1522-1946
- eISSN
- 1522-726X
- Grant note
- T32 HL007576 / NHLBI NIH HHS K23 HL141596 / NHLBI NIH HHS 16SFRN29020000 / AHA Heart Failure Strategically Focused Research Network Nora Eccles Treadwell Foundation UL1 TR002538 / NCATS NIH HHS R01 HL135121 / NHLBI NIH HHS R01 HL132067 / NHLBI NIH HHS
- Language
- English
- Date published
- 12/01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984845465702771
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