# Validation of Age-adjusted Shock indices for Predicting In-hospital outcomes in percutaneously REvascularized ST-elevation myocardial infarction - ASPIRE-STEMI study

**Authors:** Bryan Jacob Koithara, Ravi Kalra, Shashikala Sangle, Supriya Barsode, Shrikant Deshmukh

PMC · DOI: 10.1016/j.ihj.2025.10.004 · Indian Heart Journal · 2025-10-10

## TL;DR

The study validates Age-Shock Indices as simple tools to predict hospital outcomes in heart attack patients undergoing a specific treatment.

## Contribution

The study validates Age-SI and Age-MSI as alternatives to GRACE for predicting in-hospital outcomes in STEMI patients in India.

## Key findings

- Age-SI and Age-MSI showed high sensitivity for predicting MACE and mortality in STEMI patients.
- Age-SI and Age-MSI offer simple bedside risk stratification compared to the GRACE score.
- Each index independently predicted in-hospital outcomes in the study population.

## Abstract

The ASPIRE-STEMI study prospectively evaluated 236 patients with ST-elevation myocardial infarction undergoing percutaneous revascularization to validate Age-Shock Index (Age-SI) and Age-Modified Shock Index (Age-MSI) as alternatives to the GRACE score for predicting in-hospital major adverse cardiovascular events (MACE) and all-cause mortality. For MACE (n = 60), optimal cut-offs yielded sensitivities/specificities of 76.7 %/67 % (Age-SI ≥ 36.95), 85 %/56.2 % (Age-MSI ≥45.64), and 60 %/81.9 % (GRACE ≥127.5). For all-cause mortality (n = 17), optimal cut-offs yielded sensitivity/specificity of 82.4 %/83 % (Age-SI ≥46.83), 77 %/89 % (Age-MSI ≥67.35), and 94 %/76.7 % (GRACE ≥127.5). While each index independently predicted in-hospital outcomes, Age-SI and Age-MSI offer simple, bedside risk stratification in Indian STEMI patients post-PCI.

## Linked entities

- **Diseases:** myocardial infarction (MONDO:0005068)

## Full-text entities

- **Diseases:** myocardial infarction (MESH:D009203), ST-elevation (MESH:D000072657), Shock (MESH:D012769)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

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## References

13 references — full list in the complete paper: https://tomesphere.com/paper/PMC12793910/full.md

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Source: https://tomesphere.com/paper/PMC12793910