Value of shock index and modified shock index in reviewing prognosis in patients with non-ST-segment elevation myocardial infarction

An Fuwang; Yuan Yimeng

doi:10.3969/j.issn.1674-4055.2018.05.26

Abstract：Objective To investigate the value of shock index (SI) and modified shock index (MSI) in reviewing prognosis in patients with non-ST-segment elevation myocardial infarction (non-STEMI). Methods The patients with acute non-STEMI (n=86) were chosen from Emergency Department of People’s Hospital of June County from June 2013 to June 2016, and SI (SI group) and MSI (MSI group) were calculated. Taken SI=0.7 and MSI=1.4 as dividing value, the patients were divided into 4 subgroups: subgroup A (SI≥0.7, n=32), subgroup B (SI<0.7, n=54), subgroup C (MSI≥1.4, n=26) and subgroup D (MSI<1.4, n=60). The clinical data, all-cause mortality, and incidence of major adverse cardiovascular events (MACE), life-threatening arrhythmias (LTA) and cardiogenic shock (CGS) were compared in all groups. Results The difference in basic data had no statistical significance among all groups except of heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP) and percentages of grade Ⅲ and grade Ⅳ in Killip grading (P>0.05). Taken 15 d as study endpoint, all-cause mortality was 8.14%, MACE incidence was 18.61%, LTA incidence was 9.30%, and CGS incidence was 6.98%. The incidence of MACE, CGS and LTA and all-cause mortality were significantly higher in subgroup A with increased SI in subgroup C with increased MSI than those in normal group (P<0.05). The odds ratio (OR) in subgroup A and subgroup C was respectively as follows: CGS was 10.6~61.2, all-cause mortality was 5.2~13.2, MACE was 2.4~3.8, and LTA was 2.7~5.3, which were all higher in subgroup C with increased MSI than those in subgroup A with increased SI. Conclusion SI and MSI are simple and effective predictive indexes for reviewing prognosis risk factors in patients with acute non-STEMI, and MSI is more accurate relatively.