title: Modified shock index is a predictor for 7-day outcomes in patients with STEMI.
abstract: METHODS
  The aim of this study was to compare the predictive values of modified shock index (MSI) and shock index (SI) for 7-day outcome in patients with ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  This retrospective study included 160 consecutive patients with STEMI and emergency percutaneous coronary intervention. The blood pressure (BP) and heart rate (HR) measured at emergency department were used to calculate SI (HR/systolic BP) and MSI (HR/mean artery pressure). The major adverse cardiac events (MACE) included all-cause mortality, life-threatening arrhythmias, cardiogenic shock, and Killip class within 7 days.
  
  
  RESULTS
  Forty-nine patients had increased MSI (≥1.4), whereas 72 had increased SI (≥0.7). Except the parameters on BP and HR, other parameters were similar between the normal and increased SI groups. However, the increased MSI group had significantly higher age (69.0 ± 13.0 years vs 63.9 ± 12.9 years, P = .025) than the normal MSI group. The 7-day all-cause mortality was 8.8%, and MACE rate was 24.4% in this study. Both increased SI and increased MSI predicted higher MACE rates. However, the odds ratios of increased MSI for all-cause mortality (6.8 vs 3.4), cardiogenic shock (3.0 vs 1.6), life-threatening arrhythmias (9.1 vs 4.6), and MACE (6.8 vs 3.4) were higher than those of increased SI. Modified shock index and SI were independent factor for MACE, but the odds ratio of MSI was higher than of SI (3.05 vs 1.07).
  
  
  CONCLUSIONS
  Both SI and MSI in emergency department could predict the all-cause mortality and MACE rates within 7 days in patients with STEMI, but MSI may be more accurate than SI.
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: shangguan8910@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Shangguan
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: xujinsong636@sohu.com.
authors.forename: Jing-Song
authors.initials: JS
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: suyihappy@sohu.com.
authors.forename: Hai
authors.initials: H
authors.lastname: Su
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: ljx912@126.com.
authors.forename: Ju-Xiang
authors.initials: JX
authors.lastname: Li
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: wwy20080601@163.com.
authors.forename: Wen-Ying
authors.initials: WY
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: hongkui88@163.com.
authors.forename: Kui
authors.initials: K
authors.lastname: Hong
authors.affiliation: Department of Cardiology, Second Affiliated Hospital of Nanchang University. Electronic address: xiaoshumenfan@126.com.
authors.forename: Xiao-Shu
authors.initials: XS
authors.lastname: Cheng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D062186:Arterial Pressure / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012770:Shock, Cardiogenic / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology