SPC365

Shock Index-Creatinine Clearance in Acute Coronary Syndrome

Session: SESSÃO DE POSTERS 07 - DOENÇAS CARDIOVASCULARES - LESÃO RENAL AGUDA E INFLAMAÇÃO
Speaker: Oliver Correia Kungel

Congress: CPC 2025
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 13. Acute Coronary Syndromes
Subtheme: 13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type: Cartazes
FP Number: ---
Authors: Oliver Correia Kungel; Vanda Neto; Gonçalo Ferreira; Francisco Santos; Mariana Almeida; João Fiuza; Davide Moreira; António Costa

<p><span style="font-family:Arial,sans-serif"><span style="font-size:medium"><span style="color:#2a2a2a"><strong>Background:</strong> Shock Index-Creatinine Clearance score (SI-C) is a </span><span style="color:#2a2a2a">recently developed </span><span style="color:#2a2a2a">version of the shock index. </span><span style="color:#1b1b1b">These updated scor</span><span style="color:#1b1b1b">e includes renal function and</span><span style="color:#1b1b1b"> </span><span style="color:#1b1b1b">has</span><span style="color:#1b1b1b"> already </span><span style="color:#1b1b1b">been</span><span style="color:#1b1b1b"> used in ST-Elevation Myocardial Infarction patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear.&nbsp;</span><span style="color:#2a2a2a"> </span></span></span></p>

<p><span style="font-family:Arial,sans-serif"><span style="font-size:medium"><span style="color:#2a2a2a">The aim of this study was&nbsp;to </span><span style="color:#2a2a2a">evaluate the interaction between SI-C and the in-hospital mortality in ACS patients. </span></span></span></p>

<p>&nbsp;</p>

<p><span style="font-family:Arial,sans-serif"><span style="font-size:medium"><strong>Methods:</strong> A retrospective analysis of 528 patients admitted to a Cardiology ward diagnosed with ACS. Patients with chronic kidney disease were not included in this analysis. The SI-C was calculated from the data collected from the patient admission to the emergency room. The primary endpoint was defined as in-hospitality mortality. <span style="color:#1b1b1b">Analysis of significance was conducted using Chi-square analysis and Mann-Whitney U test.</span> Receiver Operating Characteristic (ROC) curve analysis was conducted to evaluate the performance of SI-C in predicting the primary outcome. <span style="color:#333333">Patients were stratified into two groups based on the optimal cut-off value determined </span><span style="color:#333333">from ROC curve.</span> </span></span></p>

<p>&nbsp;</p>

<p><span style="font-family:Arial,sans-serif"><span style="font-size:medium"><strong>Results:</strong> Mean patient age was 65.3 (&plusmn;13.7) years; 78% were male;&nbsp;9.8% of the patients died during hospital stay. No differences were found between SI-C regarding the presence of type 2 diabetes mellitus (p=0.41), arterial hypertension (p=0.49), dyslipidemia (p=0.45), smoking habits (p=0.48), obesity (p=0.49) and previous coronary artery disease (p=0.29).</span></span></p>

<p><span style="font-family:Arial,sans-serif"><span style="font-size:medium">The SI-C score was <span style="color:#2a2a2a">significantly higher</span> in the group of patients who deceased during hospital stay (15 <span style="color:#2a2a2a">&plusmn;</span> 26 vs -14 <span style="color:#2a2a2a">&plusmn;</span> 19, p&lt;0,01). <span style="color:#2a2a2a">The predictive value of SI-C for</span> in-hospitality mortality was good <span style="color:#2a2a2a">(area under the curve= 0.7</span><span style="color:#2a2a2a">11</span><span style="color:#2a2a2a">, 95% CI: 0.</span><span style="color:#2a2a2a">633-0.789</span><span style="color:#2a2a2a">, p&lt;0.001). </span><span style="color:#2a2a2a">After categorization of the SI-C, a high SI-C </span><span style="color:#2a2a2a">score</span><span style="color:#2a2a2a"> (</span><span style="color:#1b1b1b"><u>&ge;</u></span><span style="color:#1b1b1b">&thinsp;2</span><span style="color:#1b1b1b">0</span><span style="color:#1b1b1b">) </span><span style="color:#1b1b1b">was </span><span style="color:#1b1b1b">associated with a</span><span style="color:#1b1b1b">n </span><span style="color:#1b1b1b">odds ratio of 3.89 (2.09-7.30; 95% C</span><span style="color:#1b1b1b">I</span><span style="color:#1b1b1b">s)</span></span></span></p>

<p><span style="font-family:Arial,sans-serif"><span style="font-size:medium"><span style="color:#2a2a2a"><strong>Conclusion:</strong> SI-C </span><span style="color:#2a2a2a">had a good predictive value</span><span style="color:#2a2a2a"> in-hospitality mortality </span><span style="color:#2a2a2a">of patients </span><span style="color:#2a2a2a">after ACS,</span><span style="color:#1b1b1b"> particularly with a score&thinsp;</span><span style="color:#1b1b1b"><u>&ge;</u></span><span style="color:#1b1b1b">&thinsp;2</span><span style="color:#1b1b1b">0.</span></span></span></p>