Long-Term Prognosis and Risk Heterogeneity of Heart Failure Complicating Acute Myocardial Infarction

The Killip classification of acute heart failure was developed decades ago to predict short-term mortality in patients with acute myocardial infarction (AMI). The aim of this study was to determine the long-term prognosis of acute heart failure graded according to the Killip classification in 15,235...

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Bibliographic Details
Published in:The American journal of cardiology 2015-04, Vol.115 (7), p.872-878
Main Authors: de Carvalho, Leonardo P., MD, PhD, Gao, Fei, PhD, Chen, Qifeng, BSc, Sim, Ling-Ling, MS, Koh, Tian-Hai, MBBS, Foo, David, MBBS, Ong, Hean-Yee, MBBS, Tong, Khim-Leng, MBBS, Tan, Huay-Cheem, MBBS, Yeo, Tiong-Cheng, MBBS, Chow, Khuan-Yew, MBBS, Richards, A. Mark, MD, PhD, Peterson, Eric D., MD, MPH, Chua, Terrance, MBBS, Chan, Mark Y., MBBS, MHS
Format: Article
Language:English
Subjects:
Aged
Cardiovascular
Cause of Death
Electrocardiography
Fatalities
Female
Follow-Up Studies
Heart attacks
Heart Failure - epidemiology
Heart Failure - etiology
Hospital Mortality - trends
Hospitalization
Hospitals
Humans
Incidence
Male
Middle Aged
Mortality
Myocardial Infarction - complications
Myocardial Infarction - diagnosis
Myocardial Infarction - epidemiology
Prognosis
Retrospective Studies
Risk Assessment - methods
Singapore - epidemiology
Survival Rate - trends
Time Factors
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Summary:The Killip classification of acute heart failure was developed decades ago to predict short-term mortality in patients with acute myocardial infarction (AMI). The aim of this study was to determine the long-term prognosis of acute heart failure graded according to the Killip classification in 15,235 unselected patients hospitalized for AMI from 2000 to 2005. Vital status for each patient was ascertained, through to March 1, 2012, from linkage with national death records. A stepwise gradient in the adjusted hazard ratio (HR) for 12-year mortality was observed with increasing Killip class: class I (n = 10,123), HR 1.00 (reference group); class II (n = 2,913), HR 1.13 (95% confidence interval [CI] 1.06 to 1.21); class III (n = 1,217) HR 1.49 (95% CI 1.37 to 1.62); and class IV (n = 898), HR 2.80 (95% CI 2.53 to 3.10). Unexpectedly, in a landmark analysis excluding deaths
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.01.010