PMID- 31413846
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20210201
LR  - 20210201
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 6
IP  - 2
DP  - 2019
TI  - Cardiogenic shock after ST elevation myocardial infarction and IABP-SHOCK II risk 
      score validation in a cohort treated with pharmacoinvasive strategy.
PG  - e001069
LID - 10.1136/openhrt-2019-001069 [doi]
LID - e001069
AB  - OBJECTIVE: To validate the Intra-aortic Balloon Pump in Cardiogenic Shock II 
      (IABP-SHOCK II) score in patients with cardiogenic shock after ST elevation 
      myocardial infarction (STEMI) treated with pharmacoinvasive strategy (PhIS) and 
      to analyse the influence of ischaemia time on different risk strata. METHODS: We 
      analysed 2143 patients with STEMI who underwent reperfusion with tenecteplase in 
      primary health services between May 2010 and April 2017 and were transferred to a 
      tertiary hospital for cardiac catheterisation and continuity of care. Those who 
      evolved to cardiogenic shock were scored as low (0-2), moderate (3-4) or high 
      (5-9) risk of death in 30 days and pairwise-log-rank test was used to compare 
      strata. Time intervals between symptoms onset and lytic (pain-to-needle) and 
      fibrinolytic-catheterisation were also compared. RESULTS: Cardiogenic shock 
      occurred in 212 (9.9%) individuals. The 30-day mortality using the IABP-SHOCK II 
      score was 26.6% for low-risk (n=94), 53.2% for moderate-risk (n=62) and 76% for 
      high-risk (n=25) analysed patients (p<0.001). Validation of the score showed good 
      discrimination for death, area under the curve of 0.73 (CI: 0.66 to 
      0.81; p<0.001). The median intervals of pain-to-needle and 
      fibrinolytic-catheterisation showed no association with the group stratification 
      (220 vs 251 vs 200 min; p=0.22 and 390 vs 435 vs 315 min; p=0.18, respectively). 
      CONCLUSIONS: In patients with cardiogenic shock after STEMI treated with PhIS, 
      risk stratification using IABP-SHOCK II score was adequate. There was no 
      influence of pain-to-needle and fibrinolytic-catheterisation times on the ability 
      to the score model stratification.
FAU - Moraes, Pedro Ivo M
AU  - Moraes PIM
AUID- ORCID: 0000-0003-0488-0538
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
FAU - Alves, Claudia Rodrigues
AU  - Alves CR
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
FAU - Souza, Marco Tulio
AU  - Souza MT
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
FAU - Kawakami, Suzi Emiko
AU  - Kawakami SE
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
FAU - Goncalves, Iran Jr
AU  - Goncalves I Jr
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
FAU - Barbosa, Adriano Henrique Pereira
AU  - Barbosa AHP
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
FAU - Moreno, Antonio Celio
AU  - Moreno AC
AD  - Department of Cardiology, Hospital do Servidor Publico Municipal, Sao Paulo, 
      Brazil.
FAU - Caixeta, Adriano Mendes
AU  - Caixeta AM
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
AD  - Department of Cardiology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
FAU - Carvalho, Antonio Carlos
AU  - Carvalho AC
AD  - Discipline of Cardiology - Department of Medicine, Federal University of Sao 
      Paulo, Sao Paulo, Brazil.
LA  - eng
PT  - Journal Article
DEP - 20190729
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC6667936
OTO - NOTNLM
OT  - STEMI
OT  - cardiogenic shock
OT  - reperfusion
OT  - risk stratification
OT  - thrombolytic therapy
COIS- Competing interests: None declared.
EDAT- 2019/08/16 06:00
MHDA- 2019/08/16 06:01
PMCR- 2019/07/29
CRDT- 2019/08/16 06:00
PHST- 2019/04/18 00:00 [received]
PHST- 2019/06/12 00:00 [revised]
PHST- 2019/07/04 00:00 [accepted]
PHST- 2019/08/16 06:00 [entrez]
PHST- 2019/08/16 06:00 [pubmed]
PHST- 2019/08/16 06:01 [medline]
PHST- 2019/07/29 00:00 [pmc-release]
AID - openhrt-2019-001069 [pii]
AID - 10.1136/openhrt-2019-001069 [doi]
PST - epublish
SO  - Open Heart. 2019 Jul 29;6(2):e001069. doi: 10.1136/openhrt-2019-001069. 
      eCollection 2019.