Impact of the Killip class of heart failure on treatment times and intrahospital mortality among STEMI patients.

IF 2.9 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Journal of Cardiovascular Medicine Pub Date : 2025-05-01 Epub Date: 2025-04-04 DOI:10.2459/JCM.0000000000001719
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.

Killip心力衰竭分级对STEMI患者治疗时间和院内死亡率的影响
目的:虽然已知及时再灌注可以降低死亡率,但Killip系统分类的心力衰竭严重程度对治疗延迟的影响程度仍不清楚。我们的研究旨在解决st段抬高型心肌梗死(STEMI)患者出现时Killip分级与治疗时间之间存在的证据差距。方法:我们对2009年至2022年在我院治疗并在FITT-STEMI注册的患者数据进行相关分析。我们关注将患者分配到四个Killip类别的治疗时间的关系,并使用方差分析检验(显著性水平:P)。结果:总共确定了1264例患者。Killip I型患者的门到球囊时间为54(±35)min(平均±SD), Killip II型患者为53(±26)min, III型延长至77.5(±46)min, IV型延长至79.7(±45)min(总P值< 0.001)。即使排除院外心脏骤停(OHCA)患者后,这一结果仍具有统计学意义(总P值:结论:STEMI患者心力衰竭的严重程度显著影响治疗时间的持续时间。Killip III和IV级患者表现出高院内死亡率。
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来源期刊
Journal of Cardiovascular Medicine
Journal of Cardiovascular Medicine 医学-心血管系统
CiteScore
3.90
自引率
26.70%
发文量
189
审稿时长
6-12 weeks
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. ​
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