%0 Journal Article
%T Killip scale reclassification according to lung ultrasound: Killip pLUS.
%A Carreras-Mora J
%A Vidal-Burdeus M
%A Rodríguez-González C
%A Simón-Ramón C
%A Rodríguez-Sotelo L
%A Sionis A
%A Giralt-Borrell T
%A Martínez-Membrive MJ
%A Izquierdo-Marquisá A
%A Cainzos-Achirica M
%A Vaquerizo-Montilla B
%A Rivas-Lasarte M
%A Ribas-Barquet N
%J Eur Heart J Acute Cardiovasc Care
%V 13
%N 7
%D 2024 Jul 24
%M 38832853
%F 4.766
%R 10.1093/ehjacc/zuae073
%X <B>OBJECTIVE: </B>The Killip scale remains a fundamental tool for prognostic assessment in ST-segment elevation myocardial infarction (STEMI) due to its simplicity and predictive value. Lung ultrasound (LUS) has emerged as a valuable adjunct for diagnosing and predicting outcomes in heart failure (HF) and STEMI patients, even those with subclinical congestion. We created a new classification (Killip pLUS), which reclassifies Killip I and II patients into an intermediate category (Killip I pLUS) based on LUS results. This category included Killip I patients and ≥1 positive zone (≥3 B-lines) and Killip II with 0 positive zones. We aimed to evaluate this new classification by comparing it with the Killip scale and a previous LUS-based reclassification scale (LUCK scale).<BR><B>RESULTS: </B>Lung ultrasound was performed within 24 h of admission in a multicentre cohort of 373 patients admitted for STEMI. In-hospital mortality and major adverse cardiovascular events within one year after admission, comprising mortality or readmission for HF, acute coronary syndrome, or stroke, were analysed. When predicting in-hospital mortality, the global comparison of these three classifications was statistically significant: Killip pLUS area under the curve (AUC) 0.90 (95% CI 0.85-0.95) vs. Killip AUC 0.85 (95% CI 0.73-0.96) vs. LUCK 0.83 (95% CI 0.70-0.95), P = 0.024. To predict events during follow-up, the comparison between scales was also significant: Killip pLUS 0.77 (95% CI 0.71-0.85) vs. Killip 0.72 (95% CI 0.65-0.79) vs. LUCK 0.73 (95% CI 0.66-0.81), P = 0.033.<BR><B>CONCLUSIONS: </B>The Killip pLUS scale provides enhanced risk stratification compared to the Killip and LUCK scales while preserving simplicity.