Risk Assessment of Patients After ST-Segment Elevation Myocardial Infarction by Killip Classification: An
Kashif A Hashmi1, Fahar Adnan1,2, Omer Ahmed3
1Cardiology, Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, PAK.
Insights
The Killip classification effectively predicts mortality in ST-segment elevation myocardial infarction (STEMI) patients, validating its use in resource-limited settings. Higher Killip classes correlate with increased in-hospital mortality risk.
Area of Science:
- Cardiology
- Clinical Risk Stratification
Background:
- The Killip classification system assesses heart failure severity post-myocardial infarction (MI).
- Its validation in local populations is crucial for guiding treatment strategies.
- ST-segment elevation MI (STEMI) requires accurate risk stratification for improved outcomes.
Purpose of the Study:
- To revalidate the Killip classification system in a local population with STEMI.
- To determine the frequency of Killip classes (I-IV) in STEMI patients.
- To assess in-hospital mortality rates across different Killip classes post-STEMI.
Main Methods:
- Retrospective cross-sectional study design.
- Stratification of STEMI patients using the Killip classification.
- Validation through 15-day in-hospital mortality assessment per Killip class.
Main Results:
- Killip Class I: 81.4% of patients, 9.9% mortality.
- Killip Class II: 9.5% of patients, 8.7% mortality.
- Killip Class III: 5.6% of patients, 92.6% mortality.
- Killip Class IV: 3.5% of patients, 100% mortality.
- Higher Killip class, age, diabetes, smoking, and BMI >30 kg/m² were linked to increased mortality.
Conclusions:
- The Killip classification system is a valid tool for risk stratification in STEMI patients.
- The system is particularly valuable in resource-limited healthcare settings.
- Early identification of high-risk patients through Killip classification can inform timely interventions.
Abstract:
Introduction The Killip classification system was introduced for clinical assessment of patients with acute myocardial infarction (MI). It stratifies individuals according to the severity of their post-MI heart failure. This system provides effective stratification of long-term and short-term outcomes in patients with acute MI and influences the treatment strategies. Revalidation of Killip class in our local population is mandatory. We planned this study to increase cardiologist's readiness to tackle the risks associated with increased mortality in each class post ST-segment elevation MI (STEMI). Objectives were to determine the frequency of Killip classes I, II, III, and IV and in-hospital mortality in each Killip class in patients with left ventricular failure secondary to STEMI. Methods A retrospective cross-sectional study was conducted in the Department of Cardiology, Jinnah Hospital, Lahore, over a period of three years. Patients with STEMI were stratified using Killip classification, and validation was performed by determining the within 15 days in-hospital mortality in each Killip class. Results The frequency (percentage) of patients with STEMI in each Killip class from I to IV was 395 (81.4%), 46 (9.5%), 27 (5.6%), and 17 (3.5%), respectively, while the in-hospital mortality in each Killip class came out to be 39 (9.9%), 4 (8.7%), 25 (92.6%) and 17 (100%), respectively. The presence of diabetes, history of smoking, and body mass index (BMI) of more than 30 kg/m2 were significant contributors to mortality, along with higher Killip class and age of presentation. Conclusions It is concluded that the Killip classification system is a valid tool for risk stratification for patients after STEMI, especially in resource-limited countries.
More Related Videos
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:14Myocarditis III: Medical Management
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:27Myocarditis II: Clinical Features and Diagnostic Tests