Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction
Background: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) dur...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cardiologia (SBC)
2014-08-01
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| Series: | Arquivos Brasileiros de Cardiologia |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000004&lng=en&tlng=en |
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| author | Bruno Henrique Gallindo de Mello Gustavo Bernardes F. Oliveira Rui Fernando Ramos Bernardo Baptista C. Lopes Cecília Bitarães S. Barros Erick de Oliveira Carvalho Fabio Bellini P. Teixeira Guilherme D'Andréa S. Arruda Maria Sol Calero Revelo Leopoldo Soares Piegas |
| author_facet | Bruno Henrique Gallindo de Mello Gustavo Bernardes F. Oliveira Rui Fernando Ramos Bernardo Baptista C. Lopes Cecília Bitarães S. Barros Erick de Oliveira Carvalho Fabio Bellini P. Teixeira Guilherme D'Andréa S. Arruda Maria Sol Calero Revelo Leopoldo Soares Piegas |
| author_sort | Bruno Henrique Gallindo de Mello |
| collection | DOAJ |
| description | Background: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. Objective: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. Methods: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. Results: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). Conclusion: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients. |
| first_indexed | 2024-04-12T19:26:02Z |
| format | Article |
| id | doaj.art-2bc4aeeb1ff1446db533fdac1fb08a6d |
| institution | Directory Open Access Journal |
| issn | 1678-4170 |
| language | English |
| last_indexed | 2024-04-12T19:26:02Z |
| publishDate | 2014-08-01 |
| publisher | Sociedade Brasileira de Cardiologia (SBC) |
| record_format | Article |
| series | Arquivos Brasileiros de Cardiologia |
| spelling | doaj.art-2bc4aeeb1ff1446db533fdac1fb08a6d2022-12-22T03:19:28ZengSociedade Brasileira de Cardiologia (SBC)Arquivos Brasileiros de Cardiologia1678-41702014-08-01103210711710.5935/abc.20140091S0066-782X2014002000004Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial InfarctionBruno Henrique Gallindo de MelloGustavo Bernardes F. OliveiraRui Fernando RamosBernardo Baptista C. LopesCecília Bitarães S. BarrosErick de Oliveira CarvalhoFabio Bellini P. TeixeiraGuilherme D'Andréa S. ArrudaMaria Sol Calero ReveloLeopoldo Soares PiegasBackground: The classification or index of heart failure severity in patients with acute myocardial infarction (AMI) was proposed by Killip and Kimball aiming at assessing the risk of in-hospital death and the potential benefit of specific management of care provided in Coronary Care Units (CCU) during the decade of 60. Objective: To validate the risk stratification of Killip classification in the long-term mortality and compare the prognostic value in patients with non-ST-segment elevation MI (NSTEMI) relative to patients with ST-segment elevation MI (STEMI), in the era of reperfusion and modern antithrombotic therapies. Methods: We evaluated 1906 patients with documented AMI and admitted to the CCU, from 1995 to 2011, with a mean follow-up of 05 years to assess total mortality. Kaplan-Meier (KM) curves were developed for comparison between survival distributions according to Killip class and NSTEMI versus STEMI. Cox proportional regression models were developed to determine the independent association between Killip class and mortality, with sensitivity analyses based on type of AMI. Results: The proportions of deaths and the KM survival distributions were significantly different across Killip class >1 (p <0.001) and with a similar pattern between patients with NSTEMI and STEMI. Cox models identified the Killip classification as a significant, sustained, consistent predictor and independent of relevant covariables (Wald χ2 16.5 [p = 0.001], NSTEMI) and (Wald χ2 11.9 [p = 0.008], STEMI). Conclusion: The Killip and Kimball classification performs relevant prognostic role in mortality at mean follow-up of 05 years post-AMI, with a similar pattern between NSTEMI and STEMI patients.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000004&lng=en&tlng=enÍndice de Gravidade de DoençasInsuficiência Cardíaca / mortalidadeInfarto do Miocárdio / mortalidadePrognóstico |
| spellingShingle | Bruno Henrique Gallindo de Mello Gustavo Bernardes F. Oliveira Rui Fernando Ramos Bernardo Baptista C. Lopes Cecília Bitarães S. Barros Erick de Oliveira Carvalho Fabio Bellini P. Teixeira Guilherme D'Andréa S. Arruda Maria Sol Calero Revelo Leopoldo Soares Piegas Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction Arquivos Brasileiros de Cardiologia Índice de Gravidade de Doenças Insuficiência Cardíaca / mortalidade Infarto do Miocárdio / mortalidade Prognóstico |
| title | Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction |
| title_full | Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction |
| title_fullStr | Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction |
| title_full_unstemmed | Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction |
| title_short | Validation of the Killip-Kimball Classification and Late Mortality after Acute Myocardial Infarction |
| title_sort | validation of the killip kimball classification and late mortality after acute myocardial infarction |
| topic | Índice de Gravidade de Doenças Insuficiência Cardíaca / mortalidade Infarto do Miocárdio / mortalidade Prognóstico |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2014002000004&lng=en&tlng=en |
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