The CS4P score demonstrated superior prognostic performance in STEMI patients with cardiogenic shock compared to NSTEMI, with an AUC of 0.74 vs. 0.69 (p=0.05).
Does the CS4P risk score accurately predict 30-day mortality or need for renal replacement therapy in patients with infarct-related cardiogenic shock?
The CS4P risk score provides acceptable short-term mortality risk stratification in infarct-related cardiogenic shock, performing better in STEMI patients without prior CPR.
Absolute Event Rate: 0% vs 0%
Abstract Objectives The aim of this analysis was to evaluate the prognostic features of the cardiogenic shock 4 proteins (CS4P) biomarker-based risk score in patients with cardiogenic shock (CS), presenting with ST-segment elevation myocardial infarction (STEMI) vs. non-ST-segment elevation myocardial infarction (NSTEMI), with and without cardiopulmonary resuscitation (CPR). Background The CS4P risk score, validated in cohorts of CS patients with both acute coronary syndrome (ACS) and non-ACS etiologies, showed advanced predictive metrics compared with other contemporary risk prediction scores for CS. However, there is lack of data concerning the prognostic performance of the CS4P score among CS patients with different forms of ACS. Methods The present analysis is a post-hoc analysis of the randomized CULPRIT-SHOCK trial. The primary outcome was a composite of mortality or necessity for renal replacement therapy at 30-day follow-up. CS4P markers were determined in serum using ELISA assays. Results Of the 412 patients with CS included in this study, 240 (58.3%) patients had STEMI and 172 (41.7%) patients had NSTEMI. In CS patients presenting with STEMI, CS4P score exhibited better prognostication of the primary outcome compared to patients with NSTEMI (area under the curve AUC 0.74, 95% confidence interval CI 0.67–0.80 vs. AUC 0.69, 95% CI 0.61–0.77; p=0.05). Further, CS4P score displayed a higher prognostic performance in STEMI patients who had not undergone CPR prior to enrolment as compared to STEMI patients with preceding CPR (AUC 0.78; 95% CI 0.65–0.84 vs. AUC 0.70, 95% CI 0.62–0.79; p0.001). CS patients in the highest tertile of the CS4P risk score showed higher mortality rates within 30 days compared to those in the lowest tertile (Hazard ratio 1.42, 95% CI 1.11–1.82; p=0.005). Conclusion The CS4P score provides acceptable short-term mortality risk stratification among patients with CS due to acute myocardial infarction. The CS4P prediction model exhibits superior prognostication among CS patients with STEMI as compared to NSTEMI and in STEMI patients without CPR prior to hospital presentation.
Obradović et al. (Thu,) reported a other. The CS4P score demonstrated superior prognostic performance in STEMI patients with cardiogenic shock compared to NSTEMI, with an AUC of 0.74 vs. 0.69 (p=0.05).