Model for end-stage liver disease incorporating albumin score is associated with short- and long-term all-cause mortality in patients with acute myocardial infarction complicated by cardiogenic shock

Aims Liver injury is a frequent complication in patients with acute myocardial infarction complicated by cardiogenic shock (AMICS). The model for end-stage liver disease incorporating albumin (MELD-albumin) quantifies liver injury. This study assesses the association between MELD-albumin score and all-cause mortality among patients with AMICS. Methods From a retrospective cohort of 1716 consecutive patients with AMICS admitted between 2010 and 2017, we included pa- and ^results tients who survived until Day 3 and had complete laboratory data available (n = 717). The MELD-albumin was calculated using 0 to 72 h peak s-bilirubin and s-creatinine values and the lowest s-albumin value. Patients were stratified into tertiles: low, intermediate, and high MELD-albumin. The primary outcome was all-cause mortality with a follow-up of up to 14 years. Patients in the high-score group were more often female, had lower left ventricular ejection fraction, had higher lactate levels, and less suffered out-of-hospital cardiac arrest. The high-score group had a significantly higher all-cause mortality rate than the intermediate- and low-score groups at 30 days (49 vs. 35 vs. 26%, P < 0.001) and 10 years for 30-day survivors (58 vs. 46 vs. 37%, P < 0.001). Adjusted hazard ratios for mortality in the high-score group were 2.02 at 30 days [95% confidence interval (CI): 1.49–2.74, P < 0.001] and 1.86 at 10 years (95% CI: 1.18–2.92, P < 0.001). The MELD-albumin score demonstrated an area under the receiver operating curve of 0.63 (95% CI: 0.59–0.67) for predicting 30-day mortality. ^Conclusion Liver injury, quantified as MELD-albumin score, was significantly associated with short- and long-term all-cause mortality among patients with AMICS.