Predictive value of the Killip classification in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

DeGeare, Vincent S; Boura, Judith; Grines, Lorelei; O’Neill, William W.; Grines, Cindy L.

doi:10.1016/s0002-9149(01)01457-6

Cited by 145 publications

(118 citation statements)

References 6 publications

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“…This is because a stress response is accompanied by high levels of catecholamines and cortisol, and these hormones increase glycogenolysis and lipolysis and reduce insulin sensitivity, resulting in elevated glucose levels (14). Therefore, patients with elevated glucose levels may represent patients with an increased stress response, for example, due to more severe hemodynamic compromise or more extensive myocardial damage (15,16). Stress hyperglycemia increases mortality, congestive heart failure and cardiogenic shock after AMI (17).…”

Section: Discussionmentioning

confidence: 99%

The value of admission glycosylated hemoglobin level in patients with acute myocardial infarction

Cakmak

Çakmak

Cetemen

et al. 2008

Canadian Journal of Cardiology

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Section: Discussionmentioning

confidence: 99%

The value of admission glycosylated hemoglobin level in patients with acute myocardial infarction

Cakmak

Çakmak

Cetemen

et al. 2008

Canadian Journal of Cardiology

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“…4 In view of the poor prognosis of HF, aggressively identifying patients who are suitable for revascularization would appear to be justified to preserve left ventricular function, prevent left ventricular remodeling, and improve survival. Indeed, revascularization has been shown to be associated with improved survival in patients with acute myocardial infarction and HF 12,13 or shock. 14 In non-ST-segment elevation ACS, regardless of the presence of HF, three recent trials have provided consistent evidence of the benefit of early revascularization.…”

Section: Discussionmentioning

confidence: 99%

Determinants and Prognostic Impact of Heart Failure Complicating Acute Coronary Syndromes

Steg

Dabbous²,

Feldman³

et al. 2004

Circulation

473

129

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Background— Few data are available on the impact of heart failure (HF) across all types of acute coronary syndromes (ACS). Methods and Results— The Global Registry of Acute Coronary Events (GRACE) is a prospective study of patients hospitalized with ACS. Data from 16 166 patients were analyzed: 13 707 patients without prior HF or cardiogenic shock at presentation were identified. Of these, 1778 (13%) had an admission diagnosis of HF (Killip class II or III). HF on admission was associated with a marked increase in mortality rates during hospitalization (12.0% versus 2.9% [with versus without HF], P <0.0001) and at 6 months after discharge (8.5% versus 2.8%, P <0.0001). Of note, HF increased mortality rates in patients with unstable angina (defined as ACS with normal biochemical markers of necrosis; mortality rates: 6.7% with versus 1.6% without HF at admission, P <0.0001). By logistic regression analysis, admission HF was an independent predictor of hospital death (odds ratio, 2.2; P <0.0001). Admission HF was associated with longer hospital stay and higher readmission rates. Patients with HF had lower rates of catheterization and percutaneous cardiac intervention, and fewer received β-blockers and statins. Hospital development of HF (versus HF on presentation) was associated with an even higher in-hospital mortality rate (17.8% versus 12.0%, P <0.0001). In patients with HF, in-hospital revascularization was associated with lower 6-month death rates (14.0% versus 23.7%, P <0.0001; adjusted hazard ratio, 0.5; 95% CI, 0.37 to 0.68, P <0.0001). Conclusions— In this observational registry, heart failure was associated with reduced hospital and 6-month survival across all ACS subsets, including patients with normal markers of necrosis. More aggressive treatment of these patients may be warranted to improve prognosis.

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“…6 Other high-risk baseline characteristics found to be associated with developing HF include prior HF, older age, female gender, race, current smoker status, hypertension, hyperlipidemia, prior angina or stroke, peripheral vascular disease, previous coronary artery bypass graft surgery (CABG), admission diagnosis of STEMI or NSTEMI, ST-segment changes, anterior STsegment elevation, post-revascularization Q waves on ECG, right bundle branch block, LVEF< 30%, Killip class >2 at presentation, higher presenting heart rate, atrial fibrillation, ventricular tachycardia, and baseline TIMI grade 0 flow. 6,31,32,36,[41][42][43][44][45] Close attention to patients with those baseline characteristics in the setting of ACS and PCI, vigilance for early signs of HF and implementing preventive treatment, such as earlier use of the RAASB and BB might potentially lower the rate of HF during hospital stay in such patients. 6 Rare, but serious, causes of HF in patients who have STEMI include ventricular septal defect, acute mitral valve insufficiency due to ischemia or infarction and rupture of a papillary muscle or chordae.…”

Section: 12mentioning

confidence: 99%

Incidence and impact on prognosis of heart failure in Middle Eastern patients undergoing percutaneous coronary interventions

et al. 2017

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Background: Heart failure (HF) is a serious complication of percutaneous coronary intervention (PCI) that adversely impacts survival and quality of life. Aims and Objectives: We sought to study the incidence of HF in Middle Eastern patients undergoing PCI and its impact on prognosis. Materials and Methods: The first Jordanian PCI Registry was a prospective multicenter study of PCI patients who were followed for one year. Patients who developed heart failure during hospitalization had their clinical and coronary angiographic profiles and adverse outcomes compared with those in patients who did not develop HF. Results: Of 2425 patients who had PCI, 194 (8.0%) developed HF during the hospital stay. Compared with patients who did not develop HF, those who developed HF were more likely to have diabetes mellitus, prior history of myocardial infarction (MI), elevated levels of cardiac biomarkers, ST-segment elevation MI and multivessel or left anterior descending coronary artery disease (all p values<0.05). Cardiac mortality was significantly higher among patients who developed HF compared with those who did not (5.2% vs. 0.4%; p<0.0001) and at one year (11.2% vs. 1.2%; p<0.001). Multivariate analysis showed that HF during hospital stay was an independent predictor of one-year cardiac mortality (Odds ratio 6.1, 95% CI 3.3-11.1, p<0.001). At one year, readmission rates for HF and ACS were higher among HF patients. Conclusions: Certain clinical and angiographic features were associated with higher incidence of HF among Middle Eastern patients who undergo PCI. HF was associated with higher risk of death and other adverse cardiac events during hospital stay and one year of follow up.

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Predictive value of the Killip classification in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

Cited by 145 publications

References 6 publications

The value of admission glycosylated hemoglobin level in patients with acute myocardial infarction

The value of admission glycosylated hemoglobin level in patients with acute myocardial infarction

Determinants and Prognostic Impact of Heart Failure Complicating Acute Coronary Syndromes

Incidence and impact on prognosis of heart failure in Middle Eastern patients undergoing percutaneous coronary interventions

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