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 Echocardiography Killip Classification (eKillip Class) is a combined echocardiography hemodynamic assessment of 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. Methods: This is a prospective cohort study of 114 AMI patients who were obtained using a consecutive sampling technique that met the inclusion and exclusion criteria, then categorized into one of eKillip class I-IV. The follow-up duration was 30 days. The study outcomes were cardiovascular rehospitalization and mortality. Survival analysis was done using Kaplan-Meier test, and hazard ratio was estimated using a Cox proportional hazards model. 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 patients (19.3%) with cardiovascular rehospitalization and 13 patients (13.2%) with cardiovascular mortality 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). Conclusions: The eKillip Class was an independent predictor of cardiovascular rehospitalization and mortality in AMI patients. AMI 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 437-451, URL: https://www.ijscia.com/wp-content/uploads/2024/05/Volume5-Issue3-May-Jun-No.605-437-451.pdf

Volume 5 | Issue 3: May-Jun 2024