# Shock index creatinine: a new predictor of mortality in acute coronary syndrome patients

## TL;DR

The Shock Index Creatinine (SIC) score is a new tool that can predict in-hospital mortality in patients with acute coronary syndrome, with higher scores indicating greater risk.

## Contribution

This is the first study to evaluate the SIC score across all spectrums of acute coronary syndrome.

## Key findings

- High SIC scores (≥25) were significantly associated with higher in-hospital mortality (odds ratio 2.655).
- The SIC score showed acceptable predictive value with an AUC of 0.789 for in-hospital mortality in acute coronary syndrome patients.

## Abstract

The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratification patients. These updated scoring was already used in ST-Elevation Myocardial Infarction (STEMI) patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear. This study aims to evaluate and update the current SIC score to predict in-hospital mortality among patients with ACS.

A retrospective cohort, Single-centered study enrolled 1349 ACS patients aged ≥ 18 years old diagnosed with ACS was conducted between January 2018 to January 2022 who met for inclusion and exclusion criteria. Study subjects were analyzed for in-hospital mortality and evaluated using binary linear regression analysis. The area under the curve (AUC) of SIC score was obtain to predict the sensitivity and specificity.

Multivariate analysis showed that SIC score was significantly associated with in-hospital mortality. High SIC score (SIC ≥ 25) had significantly higher in-hospital mortality (p < 0.001) with odds ratio for (95% CIs) were 2.655 (1.6–4.31). Receiver operating characteristics (ROC) curve analysis determine the predictive power of SIC score for in-hospital mortality. SIC had an acceptable predictive value for in-hospital mortality (AUC = 0.789, 95% CI: 0.748–0.831, p < 0.001). The SIC score for sensitivity and specificity were, respectively, 71.5% and 74.4%, with optimal cutoff of SIC ≥ 25.

SIC had acceptable predictive value for in-hospital mortality in patients with all ACS spectrums. SIC was a useful parameter for predicting in-hospital mortality, particularly with a score ≥ 25. This is the first study to evaluate SIC in all spectrums of ACS.