Portal de investigação
Mortality risk prediction in elderly patients with cardiogenic shock: results from the CardShock study
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Hongisto, M
- Lassus, J
- Tarvasmäki, T
- Sionis, A
- San Roselló, J
- Tolppanen, H
- Kataja, A
- Jäntti, T
- Sabell, T
- Lindholm, MG
- Banaszewski, M
- Parissis, J
- Di Somma, S
- Carubelli, V
- Jurkko, R
- Masip, J
- Harjola, VP
- CardShock Study In
Unidades de investigação
Abstract
Aims This study aimed to assess the utility of contemporary clinical risk scores and explore the ability of two biomarkers [growth differentiation factor-15 (GDF-15) and soluble ST2 (sST2)] to improve risk prediction in elderly patients with cardiogenic shock. Methods and results Patients (n = 219) from the multicentre CardShock study were grouped according to age (elderly >= 75 years and younger). Characteristics, management, and outcome between the groups were compared. The ability of the CardShock risk score and the IABP-SHOCK II score to predict in-hospital mortality and the additional value of GDF-15 and sST2 to improve risk prediction in the elderly was evaluated. The elderly constituted 26% of the patients (n = 56), with a higher proportion of women (41% vs. 21%, P < 0.05) and more co-morbidities compared with the younger. The primary aetiology of shock in the elderly was acute coronary syndrome (84%), with high rates of percutaneous coronary intervention (87%). Compared with the younger, the elderly had higher in-hospital mortality (46% vs. 33%; P = 0.08), but 1 year post-discharge survival was excellent in both age groups (90% in the elderly vs. 88% in the younger). In the elderly, the risk prediction models demonstrated an area under the curve of 0.75 for the CardShock risk score and 0.71 for the IABP-SHOCK II score. Incorporating GDF-15 and sST2 improved discrimination for both risk scores with areas under the curve ranging from 0.78 to 0.84. Conclusions Elderly patients with cardiogenic shock have higher in-hospital mortality compared with the younger, but post-discharge outcomes are similar. Contemporary risk scores proved useful for early mortality risk prediction also in the elderly, and risk stratification could be further improved with biomarkers such as GDF-15 or sST2.
Dados da publicação
- ISSN/ISSNe:
- 2055-5822, 2055-5822
- Tipo:
- Article
- Páginas:
- 1398-1407
- DOI:
- 10.1002/ehf2.13224
- PubMed:
- 33522124
- Link para outro recurso:
- www.scopus.com
ESC heart failure The Heart Failure Association of the European Society of Cardiology
Citações Recebidas na Web of Science: 12
Citações Recebidas na Scopus: 13
Documentos
- Não há documentos
Filiações
Keywords
- Cardiogenic shock; Elderly; Risk prediction; Biomarker; GDF-15; sST2
Financiamento
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