Abstract
Objectives: (1) Classify cardiogenic shock stages in patients with acute decompensated heart failure using the Society for Cardiovascular Angiography and Interventions (SCAI) classification. (2) Investigate the 30-day mortality prognostic value of this classification among the study population.
Study Population and Methods: Prospective, observational study following patients with chronic heart failure admitted for acute decompensation at Bach Mai Cardiovascular Institute and Hanoi Heart Hospital. Collected clinical and paraclinical parameters upon admission, classified cardiogenic shock stages based on SCAI, and monitored patients for all-cause mortality over 30-days post-admission.
Results: Of 667 patients: 46.5% were SCAI stage A, 36.6% stage B, 15.4% stage C, 1.0% stage D, and 0.5% stage E. 30-days mortality was observed in 72 patients (10.8%). The SCAI classification was an independent mortality predictor with an HR of 2.69 (95% CI from 1.91 to 3.80; p < 0.001). Additional predictors included blood NT-proBNP levels, left ventricular ejection fraction, estimated pulmonary artery systolic pressure on echocardiography, and a history of stroke.
Conclusion: The SCAI classification is a practical tool in clinical settings, providing an independent prognostic value for 30-days mortality in patients with acute decompensated heart failure.