ASSOCIATION BETWEEN CHANGES IN SCAI CARDIOGENIC SHOCK STAGE AND
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Abstract
LONG-TERM PROGNOSIS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Objectives: This study aimed to evaluate the association between 24-hour changes in SCAI (Society for Cardiovascular Angiography and Interventions) shock stage and long-term all-cause mortality in patients with acute myocardial infarction (AMI).
Participants and
Methods: In a prospective cohort of 207 AMI patients, SCAI shock stages were assessed at admission and 24 hours later. Patients were categorized into three groups: SCAI stage improved, unchanged, or worsened. The primary outcome was all-cause mortality over a mean follow-up of 637.6 days.
Results: At 24 hours, 26.6% of patients experienced a change in SCAI stage; 14.5% had stage worsening. Worsening was observed in 19.1% of patients with initial SCAI B, 48.8% with SCAI C, and 40% with SCAI D/E. Patients with worsened SCAI had worse hemodynamic status, higher NT-proBNP and troponin levels, lower LVEF, and more in-hospital complications. Worsened SCAI stage was independently associated with increased long-term mortality (HR: 18.5; 95% CI: 10.1–33.9; p < 0.001).
Conclusions: Worsened SCAI stage within 24 hours of admission is a strong, independent predictor of long-term all-cause mortality in AMI patients.
Keywords
acute myocardial infarction, long-term mortality, SCAI stage transition