SCAI shock classification in acute myocardial infarction: Insights from the National Cardiogenic Shock Initiative.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Ivan D HansonNational Cardiogenic Shock Investigators

Abstract

We applied the cardiovascular angiography and interventions (SCAI) shock staging system to patients presenting with acute myocardial infarction and cardiogenic shock (AMI-CS) who were enrolled in the National Cardiogenic Shock Initiative (NCSI). The SCAI shock staging system provides a framework for evaluation of patients with CS based on clinical and hemodynamic parameters, but has not been validated in patients with AMI-CS managed with a contemporary treatment algorithm that incorporates early use of Impella. Consecutive patients enrolled in NCSI were identified, all of whom were managed with invasive hemodynamic guidance and supported with Impella. Patients were retrospectively categorized into appropriate SCAI shock stages, and outcomes were assessed accordingly. A total of 300 patients were included in the analysis; 182 patients (61%) presented in Stage C shock, 25 (8%) in Stage D, and 93 (31%) in Stage E. Survival to hospital discharge was 76, 76, and 58%, respectively (p = .006). Survival was <20% among patients in Stage E at 24 hr, regardless of baseline stage. There was near perfect agreement in shock staging between two independent clinicians at baseline (kappa = 0.975, 95% CI, 0.95-1.00, p < .001) and at 24 hr (kappa...Continue Reading

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Citations

Nov 21, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Cindy L Grines, J Jeffrey Marshall
Jan 4, 2021·European Heart Journal·Héctor BuenoJohann Bauersachs
Feb 9, 2021·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Cindy L Grines, Allison Dupont
Jan 18, 2021·JACC. Cardiovascular Imaging·Venu Menon
Nov 15, 2020·Current Heart Failure Reports·David A BaranJacob C Jentzer
Mar 4, 2021·Heart Failure Reviews·Tariq SuleimanVijay Kunadian
Mar 23, 2021·Interventional Cardiology Clinics·Alejandro LemorMir B Basir
May 15, 2021·Journal of the American College of Cardiology·Puja B ParikhJaved Butler
Jul 27, 2021·Frontiers in Cardiovascular Medicine·Adamantios TsangarisDemetris Yannopoulos
Aug 6, 2021·Journal of Drug Assessment·Rasha KaddouraAmar M Salam
Aug 21, 2021·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Holger ThieleSean Fitzgerald
Sep 17, 2021·European Heart Journal. Acute Cardiovascular Care·Anne FreundHolger Thiele

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