Echocardiography Killip Classification (eKillip Class) as a Predictor of Cardiovascular Rehospitalization and Mortality in Patients with Acute Myocardial Infarction

Ayu Putu Harina Ferdiyanthi*, Ida Bagus Rangga Wibhuti, and I Kadek Susila Surya Darma

Abstract

Background: Patients with acute myocardial infarction (AMI) are at risk of experiencing cardiovascular events such as rehospitalization and mortality. The eKillip Class is a combined echocardiographic hemodynamic assessment based on the Killip class, which uses stroke volume index (SVI) and diastolic function as indicators of systemic perfusion and pulmonary congestion to assess the prognosis of AMI patients. This study aims to assess the eKillip Class as a predictor of cardiovascular rehospitalization and mortality in AMI patients. Method: The research design used a prospective cohort. The independent variable is the eKillip class. The outcomes studied were cardiovascular rehospitalization and mortality. A total of 114 samples were obtained using a consecutive sampling technique that met the inclusion and exclusion criteria and were followed for 30 days. Results: eKillip Class IV was present in 39 patients (34.3%), while 25 (21.9%), 20 (17.5%), and 30 (26.3%) patients were in eKillip Classes I to III, respectively. During 30 days of follow-up, a total of 22 (19.3%) cardiovascular rehospitalizations and 13 (13.2%) cardiovascular mortalities occurred. Multivariate cox regression analysis using the backward stepwise LR method showed that eKillip Class IV is independently associated with cardiovascular rehospitalization and mortality (adjusted HR 3.7; 95%CI 1.6–8.6; p = 0.003; and adjusted HR 3.5; 95%CI 1.2–9.9; p = 0.018, respectively). eKillip Class IV had a significantly lower mean survival time and 30-day survival rate than non-eKillip Class IV in terms of cardiovascular rehospitalization (24.7 days [95%CI 21.9-27.6] and 66.7% vs. 27.9 days [95%CI 26.4-29.4] and 88%; p = 0.001) and cardiovascular mortality (23.7 days [95%CI 19.9-27.3] and 76.9% vs. 27.8 days [95%CI 26.2-29.5] and 92%; p = 0.019). Conclusion: eKillip Class is an independent predictor of cardiovascular rehospitalization and mortality in AMI patients. Patients with eKillip Class IV had lower survival rates for cardiovascular rehospitalization and mortality compared to patients with non-eKillip Class IV.

Keywords

eKillip class; acute myocardial infarction; cardiovascular rehospitalization; cardiovascular mortality

Cite This Article

Ferdiyanthi, A. P. H., Wibhuti, I. B. R., Darma, I. K. S. S. (2024). Echocardiography Killip Classification (eKillip Class) as a Predictor of Cardiovascular Rehospitalization and Mortality in Patients with Acute Myocardial Infarction. International Journal of Scientific Advances (IJSCIA), Volume 5| Issue 3: May-Jun 2024, Pages 437-456, URL: https://www.ijscia.com/wp-content/uploads/2024/05/Volume5-Issue3-May-Jun-No.605-437-456.pdf

Volume 5 | Issue 3: May-Jun 2024