BACKGROUND: Effective risk stratification is essential in the management of patients with acute myocardial infarction. Available models have not yet been studied and validated in patients treated with primary angioplasty for acute myocardial infarction. METHODS: The prognostic value of heart failure defined by Killip class and age upon admission and the impact of success and failure of the angioplasty procedure was studied in 1702 consecutive patients treated with primary angioplasty. FINDINGS: The combination of Killip class and age is a strong predictor of 30-day mortality and categorizes patients in subgroups with 30-day mortality risk ranging from 0.5 to 70%. Angioplasty failure results in a high 30-day mortality, in particular in patients with Killip class > or =II and/or age > or =70 years. A large majority of patients (72%), characterized by Killip class I and age <70 years, can be identified with a 0.5% risk of death at 30 days. INTERPRETATION: The presence of heart failure (Killip class) and age predicts 30-day mortality in patients on their way to the catheterization laboratory for primary angioplasty. This simple and effective early risk stratification, in combination with success and failure of the primary angioplasty, can be used to direct subsequent patient management.
BACKGROUND: Effective risk stratification is essential in the management of patients with acute myocardial infarction. Available models have not yet been studied and validated in patients treated with primary angioplasty for acute myocardial infarction. METHODS: The prognostic value of heart failure defined by Killip class and age upon admission and the impact of success and failure of the angioplasty procedure was studied in 1702 consecutive patients treated with primary angioplasty. FINDINGS: The combination of Killip class and age is a strong predictor of 30-day mortality and categorizes patients in subgroups with 30-day mortality risk ranging from 0.5 to 70%. Angioplasty failure results in a high 30-day mortality, in particular in patients with Killip class > or =II and/or age > or =70 years. A large majority of patients (72%), characterized by Killip class I and age <70 years, can be identified with a 0.5% risk of death at 30 days. INTERPRETATION: The presence of heart failure (Killip class) and age predicts 30-day mortality in patients on their way to the catheterization laboratory for primary angioplasty. This simple and effective early risk stratification, in combination with success and failure of the primary angioplasty, can be used to direct subsequent patient management.
Authors: Vivian G Ng; Alexandra J Lansky; Stephanie Meller; Bernhard Witzenbichler; Giulio Guagliumi; Jan Z Peruga; Bruce Brodie; Ruchit Shah; Roxana Mehran; Gregg W Stone Journal: Eur Heart J Acute Cardiovasc Care Date: 2013-10-03
Authors: A Bergstra; T Svilaas; D J van Veldhuisen; A F M van den Heuvel; I C C van der Horst; F Zijlstra Journal: Neth Heart J Date: 2007 Impact factor: 2.380