The prognostic importance of heart failure and age in patients treated with primary angioplasty.
BACKGROUND
Effective risk stratification is essential in the management of patients with acute myocardial infarction. Available models have not yet been studied and validated in patients treated with primary angioplasty for acute myocardial infarction.


METHODS
The prognostic value of heart failure defined by Killip class and age upon admission and the impact of success and failure of the angioplasty procedure was studied in 1702 consecutive patients treated with primary angioplasty.


RESULTS
The combination of Killip class and age is a strong predictor of 30-day mortality and categorizes patients in subgroups with 30-day mortality risk ranging from 0.5 to 70%. Angioplasty failure results in a high 30-day mortality, in particular in patients with Killip class > or =II and/or age > or =70 years. A large majority of patients (72%), characterized by Killip class I and age <70 years, can be identified with a 0.5% risk of death at 30 days.


CONCLUSIONS
The presence of heart failure (Killip class) and age predicts 30-day mortality in patients on their way to the catheterization laboratory for primary angioplasty. This simple and effective early risk stratification, in combination with success and failure of the primary angioplasty, can be used to direct subsequent patient management.
Henriques
Jose P S
JP
Department of Cardiology, Isala Klinieken, Locatie Weezenlanden, Groot Wezenland 20, 8011 JW Zwolle, The Netherlands.
Zijlstra
Felix
F
de Boer
Menko-Jan
MJ
van 't Hof
Arnoud W J
AW
Gosselink
A T Marcel
AT
Dambrink
Jan-Henk E
JH
Suryapranata
Harry
H
Hoorntje
Jan C A
JC
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D009426:Netherlands; D010343:Patient Admission; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013223:Statistics as Topic; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D019039:Platelet Glycoprotein GPIIb-IIIa Complex