Predictive value of IABP-SHOCK Ⅱ score for in-hospital mortality in patients with acute myocardial infarction complicated with cardiac shock

Wei Xiaohong; Liu Wenxian

doi:10.3760/j.issn.1673-4777.2018.09.001

Abstract：Objective To assess the value of IABP-SHOCK Ⅱ score in prediction of in-hospital mortality in patients with acute myocardial infarction complicated with cardiac shock.Methods From 2009 to 2015,114 cases of acute myocardial infarction complicated with cardiac shock who underwent percutaneous coronary intervention(PCI) in Beijing Anzhen Hospital,Capital Medical University were included.According to the IABP-SHOCK Ⅱ score,the patients were divided into low risk group(IABP-SHOCK Ⅱ score 0-2),medium risk group(IABP-SHOCK Ⅱ score 3-4) and high risk group (IABP-SHOCK Ⅱ score 5-9).Myocardial infarction characteristics,use of intra-aortic balloon pump and in-hospital mortality were recorded.The predictive value of IABP-SHOCK Ⅱ risk stratification for in-hospital outcomes was analyzed by receiver operating characteristic (ROC) curve.Results There were 55 cases in the low risk group,50 cases in the medium risk group and 9 cases in the high risk group.There was no significant difference of myocardial infarction site and vessel occlusion among groups(P ＞ 0.05).Rate of thrombolysis in myocardial infarction(TIMI) flow grade 3 after PCI in the high risk group was significantly lower than that in the low risk and medium risk groups[3/9 vs 96.4％ (53/55),74.0％ (37/50)] (P ＜ 0.05).Use rate of intra-aortic balloon pump in the high risk group was significantly higher than that in the low risk and medium risk groups[8/9 vs 63.6％ (35/55),58.0％ (29/50)] (P ＜0.05).In-hospital mortality in the high risk group was significantly higher than that in the low risk and medium risk groups [6/9 vs 12.7％ (7/55),36.0％ (18/50)];there was also a significant difference between the low risk and medium risk groups(P ＜ 0.05).Area under ROC curve of IABP-SHOCK Ⅱ score in predicting in-hospital mortality was 0.728 and the standard error was 0.057 (P ＜ 0.001).Conclusion IABP-SHOCK Ⅱ score shows a good value in prediction of in-hospital mortality in acute myocardial infarction patients with cardiac shock after PCI.