PMID- 37596114
OWN - NLM
STAT- MEDLINE
DCOM- 20231106
LR  - 20231228
IS  - 1879-0828 (Electronic)
IS  - 0953-6205 (Linking)
VI  - 117
DP  - 2023 Nov
TI  - Predictive value of Killip classification in MINOCA patients.
PG  - 57-65
LID - S0953-6205(23)00293-5 [pii]
LID - 10.1016/j.ejim.2023.08.011 [doi]
AB  - BACKGROUND: Killip classification is a practical clinical tool for risk 
      stratification in patients with acute myocardial infarction (AMI). However, its 
      prognostic role in myocardial infarction with non-obstructive coronary artery 
      (MINOCA) is still poorly explored. Our purpose was to evaluate the prognostic 
      role of high Killip class in the specific setting of MINOCA and compare the 
      results with a cohort of patients with obstructive coronary arteries myocardial 
      infarction (MIOCA). METHODS: This study included 2455 AMI patients of whom 255 
      were MINOCA. We compared the Killip classes of MINOCA with those of MIOCA and 
      evaluated the prognostic impact of a high Killip class, defined if greater than 
      I, on both populations' outcome. Short-term outcomes included in-hospital death, 
      re-AMI and arrhythmias. Long-term outcomes were all-cause mortality, re-AMI, 
      stroke, heart failure (HF) hospitalization and the composite endpoint of MACE. 
      RESULTS: Killip class >1 occurred in 25 (9.8%) MINOCA patients compared to 327 
      (14.9%) MIOCA cases. In MINOCA subjects, a high Killip class was associated with 
      a greater in-hospital mortality (p = 0.002) and, at long term follow-up, with a 
      three-fold increased mortality (p = 0.001) and a four-fold risk of HF 
      hospitalization (p = 0.003). Among MINOCA, a high Killip class was identified as 
      a strong independent predictor of MACE occurrence [HR 2.66, 95% CI (1.25-5.64), 
      p = 0.01] together with older age and worse kidney function while in MIOCA 
      population also left ventricular ejection fraction and troponin value predicted 
      MACE. CONCLUSIONS: Killip classification confirmed its prognostic impact on 
      short- and long-term outcomes also in a selected MINOCA population, which still 
      craves for a baseline risk stratification.
CI  - Copyright (c) 2023 European Federation of Internal Medicine. Published by Elsevier 
      B.V. All rights reserved.
FAU - Armillotta, Matteo
AU  - Armillotta M
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Amicone, Sara
AU  - Amicone S
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Bergamaschi, Luca
AU  - Bergamaschi L
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Angeli, Francesco
AU  - Angeli F
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Rinaldi, Andrea
AU  - Rinaldi A
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Paolisso, Pasquale
AU  - Paolisso P
AD  - Department of Advanced Biomedical Sciences, University Federico II, Naples, 
      Italy.
FAU - Stefanizzi, Andrea
AU  - Stefanizzi A
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Sansonetti, Angelo
AU  - Sansonetti A
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Impellizzeri, Andrea
AU  - Impellizzeri A
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Bodega, Francesca
AU  - Bodega F
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Canton, Lisa
AU  - Canton L
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Suma, Nicole
AU  - Suma N
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Fedele, Damiano
AU  - Fedele D
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Bertolini, Davide
AU  - Bertolini D
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Foa, Alberto
AU  - Foa A
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy.
FAU - Pizzi, Carmine
AU  - Pizzi C
AD  - Cardiology Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Bologna, 
      Italy; Department of Medical and Surgical Sciences - DIMEC - Alma Mater 
      Studiorum, University of Bologna, Bologna, Italy. Electronic address: 
      carmine.pizzi@unibo.it.
LA  - eng
PT  - Journal Article
DEP - 20230816
PL  - Netherlands
TA  - Eur J Intern Med
JT  - European journal of internal medicine
JID - 9003220
SB  - IM
MH  - Humans
MH  - MINOCA
MH  - Hospital Mortality
MH  - Stroke Volume
MH  - Ventricular Function, Left
MH  - *Myocardial Infarction
MH  - Prognosis
MH  - *Heart Failure/complications
MH  - Risk Factors
MH  - Coronary Angiography
OTO - NOTNLM
OT  - Acute myocardial infarction
OT  - Killip classification
OT  - MINOCA
OT  - MIOCA
OT  - Outcomes
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper.
EDAT- 2023/08/19 11:42
MHDA- 2023/11/06 06:42
CRDT- 2023/08/18 21:59
PHST- 2023/05/24 00:00 [received]
PHST- 2023/07/20 00:00 [revised]
PHST- 2023/08/08 00:00 [accepted]
PHST- 2023/11/06 06:42 [medline]
PHST- 2023/08/19 11:42 [pubmed]
PHST- 2023/08/18 21:59 [entrez]
AID - S0953-6205(23)00293-5 [pii]
AID - 10.1016/j.ejim.2023.08.011 [doi]
PST - ppublish
SO  - Eur J Intern Med. 2023 Nov;117:57-65. doi: 10.1016/j.ejim.2023.08.011. Epub 2023 
      Aug 16.