View : 110 Download: 2

Differential Prognostic Impact of IABP-SHOCK II Scores According to Treatment Strategy in Cardiogenic Shock Complicating Acute Coronary Syndrome: From the RESCUE Registry

Title
Differential Prognostic Impact of IABP-SHOCK II Scores According to Treatment Strategy in Cardiogenic Shock Complicating Acute Coronary Syndrome: From the RESCUE Registry
Authors
KimBum SungJangWoo JinChoiKi HongSung HeaYuCheol WoongJeongJin-OkLeeHyun JongGwonHyeon-CheolHyun-JoongYangJeong Hoon
Ewha Authors
장우진
SCOPUS Author ID
장우진scopusscopus
Issue Date
2024
Journal Title
Medicina (Lithuania)
ISSN
1010-660XJCR Link
Citation
Medicina (Lithuania) vol. 60, no. 1
Keywords
acute coronary syndromecardiogenic shockextracorporeal membrane oxygenationintra-aortic balloon pumping
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
Background: Early risk stratification is necessary for optimal determination of the treatment strategy in cardiogenic shock (CS) complicating acute coronary syndrome (ACS). Therefore, we evaluated the prognostic impact of an intra-aortic balloon pump on the cardiogenic shock (IABP-SHOCK) II score according to the treatment strategies in ACS complicated by CS using the RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock) registry. Methods: The RESCUE registry contains multicenter observational retrospective and prospective cohorts that include 1247 patients with CS from 12 centers in Korea. A total of 865 patients with ACS complicated by CS were selected and stratified into low-, intermediate- and high-risk categories according to their IABP-SHOCK II scores and then according to treatment: non-mechanical support, IABP, and extracorporeal membrane oxygenators (ECMOs). The primary outcome was all-cause mortality during follow-up. Results: The observed mortality rates for the low-, intermediate-, and high-IABP-SHOCK II score risk categories were 28.8%, 52.4%, and 69.8%, respectively (p < 0.01). Patients in the non-mechanical support and IABP groups showed an increasingly elevated risk of all-cause mortality as their risk scores increased from low to high. In the ECMO group, the risk of all-cause mortality did not differ between the intermediate- and high-risk categories (HR = 1.21, 95% CI: 0.81–1.81, p = 0.33). The IABP-SHOCK II scores for the non-mechanical support and IABP groups showed a better predictive performance (area under curve [AUC] = 0.70, 95% CI: 0.65–0.76) for mortality compared with the EMCO group (AUC = 0.61, 95% CI 0.54–0.67; p-value for comparison = 0.02). Conclusions: Risk stratification using the IABP-SHOCK II score is useful for predicting mortality in ACS complicated by CS when patients are treated with non-mechanical support or IABP. However, its prognostic value may be unsatisfactory in severe cases where patients require ECMOs. © 2024 by the authors.
DOI
10.3390/medicina60010183
Appears in Collections:
의료원 > 의료원 > Journal papers
Files in This Item:
medicina-60-00183.pdf(979.08 kB) Download
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

BROWSE