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SCAI classification as a predictor of mortality in cardiogenic shock: what is the best time to classify patients?
Session:
SESSÃO DE POSTERS 35 - DOENÇAS CARDIOVASCULARES - CHOQUE CARDIOGÉNICO 1
Speaker:
Marta Catarina Almeida
Congress:
CPC 2025
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
14. Acute Cardiac Care
Subtheme:
14.4 Acute Cardiac Care – Cardiogenic Shock
Session Type:
Cartazes
FP Number:
---
Authors:
Marta Catarina Almeida; Catarina Pohle; André Lobo; Marta Leite; Inês Neves; Adelaide Dias; Daniel Caeiro; Marisa Silva; Marta Ponte; Pedro Teixeira; Ricardo Fontes-Carvalho
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Background:</span></strong><span style="font-family:"Arial",sans-serif"> Cardiogenic shock (CS) can be categorized by severity as proposed by the Society for Cardiovascular Angiography and Interventions (SCAI). When applied retrospectively for research purposes, SCAI classification poses challenges, particularly regarding timing of the classification. </span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Purpose: </span></strong><span style="font-family:"Arial",sans-serif">The aim of the study was to compare the time of SCAI classification and its correlation with mortality.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Methods:</span></strong><span style="font-family:"Arial",sans-serif"> A retrospective study of 175 patients with CS in a tertiary intensive cardiac care unit between 2018 and 2022 was done. SCAI classification based on information at admission (SCAI 0) and with data up to six hours after admission (SCAI 6) was done. Mortality outcomes at 30 days and 1 year were registered. Chi-square test was used to test the association between SCAI classifications and mortality at 30 days and 1-year and logistic regression was used to predict mortality.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Results:</span></strong><span style="font-family:"Arial",sans-serif"> At SCAI 0, 38 patients (21.7%) were classified as stage A, 36 (20.6%) at stage B, 54 (30.9%) at stage C, 7 (4,0%) at stage D and 40 (22.9%) at stage E. Based on SCAI 6, 14 patients (8.0%) were on a stage A, 28 (16.0%) at stage B, 65 (37.1%) at stage C, 41 (23.4%) at stage D and 27 (15.4%) at stage E. There was a statistically significant difference between the distribution of SCAI classification at SCAI 0 and SCAI 6 (p < 0.001), exposed in Graph 1. SCAI 0 did not correlate with mortality at 30 days (p 0.938) nor 1-year (p 0.863). SCAI 6 was associated with mortality at 30 days (R<sup>2</sup> = 0.135, p < 0.001) and with mortality at 1-year (R<sup>2</sup> = 0.129, p = 0.002).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Conclusion:</span></strong><span style="font-family:"Arial",sans-serif"> SCAI classification has challenges related to the retrospective collection of data, with frequent missing information or omission of the real timing of the data registered. Doing a classification based on data from the admission and evolution during the first six hours showed a significant difference and only using data up to six hours after admission was correlated with mortality. This study may suggest that assignment of the SCAI shock stage done later after admission may help better classify and predict mortality in patients with cardiogenic shock.</span></span></span></p>
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