Diego Ramonfaur, David E Hinojosa-González, José G Paredes-Vázquez
{"title":"Killip-Kimball classification in octogenarians with acute coronary syndrome: An 11-year experience.","authors":"Diego Ramonfaur, David E Hinojosa-González, José G Paredes-Vázquez","doi":"10.24875/ACM.21000046","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of the study is to validate the use of the Killip-Kimball classification (KC) as a predictor of outcomes in an octogenarian cohort with acute coronary syndrome.</p><p><strong>Methods: </strong>A retrospective analysis of patients who underwent a catheterization procedure for acute coronary syndrome (ACS) was performed. ACS was defined as per the American Heart Association guidelines, and included ST-elevation myocardial infarction (STEMI), non-STEMI and Unstable Angina. We determined factors associated with the KC upon admission to the emergency room. Likewise, we compared in-hospital mortality, length of stay, and other outcomes dividing the patients by KC.</p><p><strong>Results: </strong>A total of 133 patients with a mean age of 83 years were analyzed and assigned a KC from 1 to 4 according to clinical presentation. Each group included 86, 9, 23, and 15 patients, respectively. In-hospital mortality was 12%, 5% in KC-I, 11% in KC-II, 22% in KC-III, and 40% in KC-IV with a significant difference between classes (p = 0.002). In addition, we found higher KC groups to be associated with acute kidney injury during the hospitalization (p < 0.01).</p><p><strong>Conclusion: </strong>Despite a strong reduction in mortality for elderly patients with ACS in recent decades, patients presenting with ACS and higher KC have a high mortality rate, as described in younger cohorts. KC remains a reliable prognostic tool, with applicability in octogenarian patients.</p>","PeriodicalId":8360,"journal":{"name":"Archivos de cardiologia de Mexico","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archivos de cardiologia de Mexico","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24875/ACM.21000046","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 1
Abstract
Objective: The objective of the study is to validate the use of the Killip-Kimball classification (KC) as a predictor of outcomes in an octogenarian cohort with acute coronary syndrome.
Methods: A retrospective analysis of patients who underwent a catheterization procedure for acute coronary syndrome (ACS) was performed. ACS was defined as per the American Heart Association guidelines, and included ST-elevation myocardial infarction (STEMI), non-STEMI and Unstable Angina. We determined factors associated with the KC upon admission to the emergency room. Likewise, we compared in-hospital mortality, length of stay, and other outcomes dividing the patients by KC.
Results: A total of 133 patients with a mean age of 83 years were analyzed and assigned a KC from 1 to 4 according to clinical presentation. Each group included 86, 9, 23, and 15 patients, respectively. In-hospital mortality was 12%, 5% in KC-I, 11% in KC-II, 22% in KC-III, and 40% in KC-IV with a significant difference between classes (p = 0.002). In addition, we found higher KC groups to be associated with acute kidney injury during the hospitalization (p < 0.01).
Conclusion: Despite a strong reduction in mortality for elderly patients with ACS in recent decades, patients presenting with ACS and higher KC have a high mortality rate, as described in younger cohorts. KC remains a reliable prognostic tool, with applicability in octogenarian patients.