ArticleActa Cardiologica Sinica2026
Novel Mortality Index Unveils Smoking's Role in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention.
Article in Acta Cardiologica Sinica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Early risk stratification is crucial in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). Conventional indices fail to fully capture the combined effects of hemodynamic compromise and hypoxemia. The Hypoxia-Age-Shock Index (HASI) integrates age, circulatory status, and peripheral oxygen saturation (SpO Methods: This retrospective cohort study included 711 STEMI patients (455 smokers, 256 non-smokers) treated with primary PCI from 2019 to 2022. Shock Index (SI), Age Shock Index (ASI) and HASI were calculated using vital signs and SpO Results: The HASI demonstrated superior discrimination for in-hospital mortality compared to the ASI and SI (area under the curve 0.747 vs. 0.700 and 0.628). At a cutoff of 0.524, the HASI showed high sensitivity (97.5%). Multivariable analysis identified HASI [odds ratio (OR) 8.14, 95% confidence interval (CI) 1.59-10.05] as an independent predictor; smoking was not significant (OR 0.81, 95% CI 0.36-1.84). Kaplan-Meier analysis showed comparable 30- and 120-day survival between smokers and non-smokers. Conclusions: The HASI is a rapid, non-invasive, easily computed triage tool that outperformed conventional indices in predicting mortality in STEMI patients undergoing primary PCI in this study. Acute physiological derangements, rather than smoking, drove the outcomes. Its simplicity and speed make the HASI particularly valuable for immediate pre-laboratory risk stratification in high-volume or resource-limited emergency settings.
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