International journal of cardiology. Heart & vasculature
Mortality risk stratification in contemporary myocardial infarction-related cardiogenic shock: development of AMICS-ADMIT prediction model and benchmarking of established scores
By Mihali K, Markus B, Neuner K and 7 others.
Abstract
Background
Mortality risk stratification in acute myocardial infarction complicated by cardiogenic shock (AMI-CS) remains challenging with heterogeneous temporary mechanical circulatory support (tMCS) use. We developed and temporally validated the admission-based AMICS-ADMIT model and bedside score and benchmarked them against established scores.
Methods
This retrospective single-centre study, reported according to TRIPOD+AI, included 479 consecutive patients with AMI-CS undergoing percutaneous coronary intervention (PCI) between January 2017 and July 2025. The primary endpoint was in-hospital mortality. AMICS-ADMIT was developed using multivariable logistic regression in the 2017-2022 cohort, internally evaluated by bootstrap resampling, and temporally validated in the 2023-2025 cohort. Missing data were multiply imputed. Performance was assessed using discrimination, calibration, and Brier scores. Benchmarking against CardShock, IABP-SHOCK II, and GRACE was restricted to temporal validation; tMCS-stratified performance was exploratory.