Lourdes Vicent1, Jesús Velásquez-Rodríguez1, María Jesús Valero-Masa1, Felipe Díez-Delhoyo1, Hugo González-Saldívar1, Vanessa Bruña1, Carolina Devesa1, Miriam Juárez1, Iago Sousa-Casasnovas1, Francisco Fernández-Avilés2, Manuel Martínez-Sellés3. 1. Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain. 2. Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain; Universidad Complutense, Madrid, Spain. 3. Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain; Universidad Complutense, Madrid, Spain; Universidad Europea, Madrid, Spain. Electronic address: mmselles@secardiologia.es.
Abstract
BACKGROUND/ INTRODUCTION: Outcome after ST segment elevation myocardial infarction (STEMI), has improved but patients with high Killip class still have a poor prognosis, and those ≥II need a closer monitoring in a specialized cardiac care unit. PURPOSE: We aimed to determine the predictors of Killip class in a group of patients admitted for acute STEMI. METHODS: Non-interventional registry in a Cardiac Intensive Care Unit. Patients were consecutively included from January 2010 to April 2015, and multivariate analysis was performed to determine independent predictors of high Killip Class. RESULTS: We included 1111 patients, mean age was 64.0±14.0years and 258 (23.2%) were female. Primary percutaneous coronary intervention was performed in 991 (89.2%), and 120 (10.8%) only received thrombolysis as acute reperfusion therapy. A total of 230 (20.7%) were in class II or higher. The independent predictors of Killip≥II were (odds ratio [95% confidence interval]): older age (2.1 [1.4-3.0]), female sex (1.6 [1.1-2.2]), diabetes (1.4 [1.0-2.1]), prior heart failure (3.2 [1.4-7.2]), chronic kidney disease (2.0 [1.1-3.6]), anaemia (3.0 [2.0-4.5]), multivessel disease (1.6 [1.1-2.2]), anterior location (2.4 [1.8-3.4]), time of evolution>2h (1.6 [1.1-2.4]), and TIMI flow-grade<3 (1.8 [1.2-2.7]). In-hospital mortality increased with Killip class (I 1.5%, II 3.7%, III 16.7%, IV 36.7%). CONCLUSION: In patients with STEMI Killip class can be predicted with variables available when primary percutaneous coronary intervention is performed and is strongly associated with in-hospital prognosis.
BACKGROUND/ INTRODUCTION: Outcome after ST segment elevation myocardial infarction (STEMI), has improved but patients with high Killip class still have a poor prognosis, and those ≥II need a closer monitoring in a specialized cardiac care unit. PURPOSE: We aimed to determine the predictors of Killip class in a group of patients admitted for acute STEMI. METHODS: Non-interventional registry in a Cardiac Intensive Care Unit. Patients were consecutively included from January 2010 to April 2015, and multivariate analysis was performed to determine independent predictors of high Killip Class. RESULTS: We included 1111 patients, mean age was 64.0±14.0years and 258 (23.2%) were female. Primary percutaneous coronary intervention was performed in 991 (89.2%), and 120 (10.8%) only received thrombolysis as acute reperfusion therapy. A total of 230 (20.7%) were in class II or higher. The independent predictors of Killip≥II were (odds ratio [95% confidence interval]): older age (2.1 [1.4-3.0]), female sex (1.6 [1.1-2.2]), diabetes (1.4 [1.0-2.1]), prior heart failure (3.2 [1.4-7.2]), chronic kidney disease (2.0 [1.1-3.6]), anaemia (3.0 [2.0-4.5]), multivessel disease (1.6 [1.1-2.2]), anterior location (2.4 [1.8-3.4]), time of evolution>2h (1.6 [1.1-2.4]), and TIMI flow-grade<3 (1.8 [1.2-2.7]). In-hospital mortality increased with Killip class (I 1.5%, II 3.7%, III 16.7%, IV 36.7%). CONCLUSION: In patients with STEMI Killip class can be predicted with variables available when primary percutaneous coronary intervention is performed and is strongly associated with in-hospital prognosis.
Authors: Yu Ri Kim; Myung Ho Jeong; Min Jeong An; Xiongyi Han; Kyung Hoon Cho; Doo Sun Sim; Young Joon Hong; Ju Han Kim; Youngkeun Ahn Journal: Yonsei Med J Date: 2022-02 Impact factor: 2.759
Authors: Kamran Ahmed Khan; Rajesh Kumar; Jehangir Ali Shah; Fawad Farooq; Quratulain Shaikh; Dileep Kumar; Jawaid Akbar Sial; Tahir Saghir; Abdul Samad Achakzai; Musa Karim Journal: SAGE Open Med Date: 2022-03-31