Konstantinos Avranas, Marcus Mittag, Kerstin Schadow, Kerstin Eck, Ralf Lehmann
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引用次数: 0
Abstract
Aims: While timely reperfusion is known to reduce mortality, the extent to which the severity of heart failure, as classified by the Killip system, influences treatment delays remains unclear. Our study aims to address the existing gap in evidence regarding the relationship between Killip classification at presentation and treatment times in ST-elevation myocardial infarction (STEMI) patients.
Methods: We conducted a correlative analysis using data from patients treated in our hospital and enrolled in the FITT-STEMI Register from 2009 to 2022. We focused on the relation of treatment times allocating patients into the four Killip classes and used an ANOVA test (significance level: P < 0.05). Killip class and intrahospital mortality were studied via binary logistic regression.
Results: In total, 1264 patients were identified. Door-to-balloon time among Killip I patients was 54 (±35) min (mean ± SD) and 53 (±26) min among Killip II and prolonged up to 77.5 (±46) min for class III and 79.7 (±45) min for class IV (overall P -value < 0.001). This remained statistically significant even after the exclusion of patients with out-of-hospital cardiac arrest (OHCA) (overall P -value: <0.001).Post hoc analysis showed a significant difference between Killip II and III classes for both all-comers ( P = 0.014) as well as after the exclusion of OHCA patients ( P = 0.012).Intrahospital mortality increased from <5% for classes I and II up to 10.3% for class III and 35.4% for class IV.
Conclusion: The severity of heart failure among STEMI patients significantly affects the duration of treatment times. Patients presenting with Killip class III and IV demonstrate high intrahospital mortality rates.
期刊介绍:
Journal of Cardiovascular Medicine is a monthly publication of the Italian Federation of Cardiology. It publishes original research articles, epidemiological studies, new methodological clinical approaches, case reports, design and goals of clinical trials, review articles, points of view, editorials and Images in cardiovascular medicine.
Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.