{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:59:41Z","timestamp":1785117581058,"version":"3.55.0"},"reference-count":33,"publisher":"IMR Press","issue":"5","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Noncommunicable Chronic Diseases\u2014National Science and Technology Major Project","award":["2025ZD0547900"],"award-info":[{"award-number":["2025ZD0547900"]}]},{"DOI":"10.13039\/501100017702","name":"Innovation and Entrepreneurship Talent Project of Lanzhou","doi-asserted-by":"crossref","award":["2021-RC-92"],"award-info":[{"award-number":["2021-RC-92"]}],"id":[{"id":"10.13039\/501100017702","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background:Although the Society for Cardiovascular Angiography and Intervention (SCAI) five-stage system provides a structured approach to shock assessment, the prognostic utility of this system in patients with acute myocardial infarction and cardiogenic shock (AMICS) supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO), particularly when combined with dynamic cardiac biomarkers, has not been fully validated.Methods:This single-center, hospital-based, prospective registry study, we continuously enrolled patients with AMICS who received VA-ECMO support at the Cardiac Centre of the First Hospital of Lanzhou University between January 2020 and October 2023, using data from the Chinese Society of Extracorporeal Life Support (CSECLS) registry. Patients were assigned to Stage D or E groups according to the SCAI shock staging system. Clinical characteristics and biomarkers were compared between the two groups, and a multivariate logistic regression model was used to examine the associations among shock stage, cardiac biomarkers, and in-hospital mortality.Results:This study included 119 patients with AMICS receiving VA-ECMO support, of whom 78 were classified as Stage D and 41 as Stage E. Compared with Stage D patients, Stage E patients had lower VA-ECMO survival scores (\u201310 vs \u20132; p &lt; 0.001), left ventricular ejection fraction (EF) (0.26 vs 0.33, p = 0.050), and high-density lipoprotein cholesterol (HDL-C) levels (0.78 vs 0.89; p = 0.013). However, Stage E patients had a higher incidence of ventricular tachycardia and fibrillation (53.7% vs 34.6%, p = 0.045), as well as higher glucose levels (14.85 vs 9.54; p = 0.016), triglyceride-glucose index (2.29 vs 1.72, p = 0.011) and lactate concentration (12.9 vs 9.1; p = 0.016). Cardiac troponin I, myoglobin and creatine kinase-MB levels, as well as the associated temporal variation patterns, differed significantly between the two groups. In-hospital mortality rate was significantly higher in Stage E patients than in Stage D individuals (78% vs 53.8%; p = 0.010). Multivariate logistic regression analysis showed that combining SCAI shock staging with age, troponin I 6-0, and myoglobin 24-0 significantly improved the prediction of mortality risk (area under the receiver operating characteristic (ROC) curve = 0.791). The 1-year follow-up survival rate was higher in Stage D patients (37.2%) than in Stage E individuals (19.5%).Conclusion:Combining SCAI shock staging with the dynamic monitoring of cardiac biomarkers facilitates the early risk stratification in patients with AMICS receiving VA-ECMO support, and demonstrates good predictive value for in-hospital mortality.<\/jats:p>","DOI":"10.31083\/rcm46066","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T01:28:22Z","timestamp":1785115702000},"source":"Crossref","is-referenced-by-count":0,"title":["Exploration of the Clinical Assessment and Prognostic Value of Society for Cardiovascular Angiography and Intervention Shock Staging in Patients With Acute Myocardial Infarction and Cardiogenic Shock on Veno-arterial Extracorporeal Membrane Oxygenation Support"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0819-4712","authenticated-orcid":true,"given":"Kang","family":"Dong","sequence":"first","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2205-1581","authenticated-orcid":true,"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1935-8806","authenticated-orcid":true,"given":"Chenliang","family":"Pan","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiting","family":"Cai","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6830-7068","authenticated-orcid":true,"given":"Juan","family":"Ma","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Bai","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9188-577X","authenticated-orcid":true,"given":"Junchu","family":"Wei","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6138-4450","authenticated-orcid":true,"given":"Andong","family":"Lu","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8687-7182","authenticated-orcid":true,"given":"Ming","family":"Bai","sequence":"additional","affiliation":[{"name":"The First School of Clinical Medicine of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Heart Center, The First Hospital of Lanzhou University, 730000 Lanzhou, Gansu, China"},{"name":"Gansu Province Clinical Research Center for Cardiovascular Diseases, 730000 Lanzhou, Gansu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Samsky MD, Morrow DA, Proudfoot AG, Hochman JS, Thiele H, Rao SV. 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Advanced Percutaneous Mechanical Circulatory Support Devices for Cardiogenic Shock. Critical Care Medicine, 2017, 45: pp. 1922-1929.","DOI":"10.1097\/CCM.0000000000002676"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Naidu SS, Baran DA, Jentzer JC, Hollenberg SM, van Diepen S, Basir MB, et al. SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies: This statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCCM), and Society of Thoracic Surgeons (STS) in December 2021. Journal of the Society for Cardiovascular Angiography & Interventions, 2022, 1: pp. 100008.","DOI":"10.1016\/j.jscai.2021.100008"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Baran DA, Grines CL, Bailey S, Burkhoff D, Hall SA, Henry TD, et al. SCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019. Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions, 2019, 94: pp. 29-37.","DOI":"10.1002\/ccd.28329"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Jentzer JC, van Diepen S, Barsness GW, Henry TD, Menon V, Rihal CS, et al. Cardiogenic Shock Classification to Predict Mortality in the Cardiac Intensive Care Unit. 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