Determining the Predicting value of the Shock Index in Early prediction of mortality in Patients with Acute Myocardial Infarction under Primary PCI

Introduction: shock index (heart rate (HR) divided by systolic blood pressure (SBP)) may play a substantial role in evaluation and prediction of cardiovascular events, especially in the patients with ischemic heart disease under cardiac procedures. The present study attempted to evaluate the predictive value of the shock index in early prediction of mortality in patients with acute myocardial infarction under primary PCI.Method: ۲۰۰ patients with acute myocardial infarction who were candidates for primary PCI and were gone under which at Seyedoshohada Hospital in Urmia, participated in this study. At the time of admission, the indexes of heart rate and blood pressure were determined, the shock index (heart rate (HR) divided by systolic blood pressure (SBP)) was calculated, and hence, the patients were divided into two groups: one group with an index lower than or equal to ۰.۷ and the other one with an index of more than ۰.۷. SPSS ۲۱ software was used to analyze the above study.Results: in this study, the frequency of hospital mortality in the group with a lower shock index was lower than the group with a higher shock index (p-value = ۰.۰۰۱). According to the evaluation of the area under ROC curve, the shock index was of a high capability to predict hospital mortality (the area under ROC curve = ۰.۸۹۵; p-value<۰.۰۰۱). At the cutpoint of ۰.۷, the shock index with the sensitivity of ۷۰% and the specificity of ۸۸.۴% was the predictor of hospital mortality. Similarly, according to the evaluation of the area under ROC curve, the shock index was of a high capability to predict mid-term mortality after hospital discharge (the area under ROC curve = ۰.۸۸۸; p-value<۰.۰۰۱). At the cutpoint of ۰.۷, the shock index with the sensitivity of ۱۰۰% and the specificity of ۸۶.۹% was the predictor of mid-term mortality.Conclusion: the shock index was of a high value in predicting both hospital mortality and mid-term mortality in patients with acute myocardial infarction under primary PCI.