{"id":"d9979ce3124d","type":"article","url":"https://hartvaat.nl/2017/04/18/risicostratificatie-bij-cardiogene-shock-na-acuut-myocardinfarct/","title":"Risicostratificatie bij cardiogene shock na acuut myocardinfarct","title_en":"Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","biomarkers-cardiovasculair","cardiogene-shock","myocardinfarct"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2017.02.027","source_url":"https://doi.org/10.1016/j.jacc.2017.02.027","authors":["Janine Pöss","Jelena Köster","Georg Fuernau","Ingo Eitel","Suzanne de Waha","Taoufik Ouarrak","Johan Lassus","Veli-Pekka Harjola","Uwe Zeymer","Holger Thiele","Steffen Desch"],"significance":6,"published":"2017-04-18","source_date":"2017-04-18","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/vasculair/longembolie/"],"congress":"","summary_en":"This study developed risk stratification tools for patients with cardiogenic shock after acute MI, identifying prognostic factors that can guide the intensity of mechanical circulatory support and treatment escalation decisions.","created":"2026-07-03T10:26:39Z","updated":"2026-07-03T13:25:58Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar risicostratificatiemethoden bij patiënten met cardiogene shock na acuut MI. Identificeert prognostische factoren voor het sturen van behandelintensiteit.","abstract_original":"BACKGROUND: Mortality in cardiogenic shock (CS) remains high. Early risk stratification is crucial to make adequate treatment decisions. OBJECTIVES: This study sought to develop an easy-to-use, readily available risk prediction score for short-term mortality in patients with CS, derived from the IABP-SHOCK II (Intraaortic Balloon Pump in Cardiogenic Shock) trial. METHODS: The score was developed using a stepwise multivariable regression analysis. RESULTS: Six variables emerged as independent predictors for 30-day mortality and were used as score parameters: age >73 years, prior stroke, glucose at admission >10.6 mmol/l (191 mg/dl), creatinine at admission >132.6 μmol/l (1.5 mg/dl), Thrombolysis In Myocardial Infarction flow grade <3 after percutaneous coronary intervention, and arterial blood lactate at admission >5 mmol/l. Either 1 or 2 points were attributed to each variable, leading to a score in 3 risk categories: low (0 to 2), intermediate (3 or 4), and high (5 to 9). The observed 30-day mortality rates were 23.8%, 49.2%, and 76.6%, respectively (p < 0.0001). Validation in the IABP-SHOCK II registry population showed good discrimination with an area under the curve of 0.79. External validation in the CardShock trial population (n = 137) showed short-term mortality rates of 28.0% (score 0 to 2), 42.9% (score 3 to 4), and 77.3% (score 5 to 9; p < 0.001) and an area under the curve of 0.73. Kaplan-Meier analysis revealed a stepwise increase in mortality between the different score categories (0 to 2 vs. 3 to 4: p = 0.04; 0 to 2 vs. 5 to 9: p = 0.008). CONCLUSIONS: The IABP-SHOCK II risk score can be easily calculated in daily clinical practice and strongly correlated with mortality in patients with infarct-related CS. It may help stratify patient risk for short-term mortality and might, thus, facilitate clinical decision making. (Intraaortic Balloon Pump in Cardiogenic Shock II [IABP-SHOCK II]; NCT00491036)."}