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Predictors of high Killip class after ST segment elevation myocardial infarction in the era of primary reperfusion.

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.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Vicent L,Velásquez-Rodríguez J,Valero-Masa MJ,Díez-Delhoyo F,González-Saldívar H,Bruña V,Devesa C,Juárez M,Sousa-Casasnovas I,Fernández-Avilés F,Martínez-Sellés M

doi

10.1016/j.ijcard.2017.07.038

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

46-50

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(17)31542-5

journal_volume

248

pub_type

杂志文章

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