{Reference Type}: Journal Article
{Title}: Killip scale reclassification according to lung ultrasound: Killip pLUS.
{Author}: Carreras-Mora J;Vidal-Burdeus M;Rodríguez-González C;Simón-Ramón C;Rodríguez-Sotelo L;Sionis A;Giralt-Borrell T;Martínez-Membrive MJ;Izquierdo-Marquisá A;Cainzos-Achirica M;Vaquerizo-Montilla B;Rivas-Lasarte M;Ribas-Barquet N;
{Journal}: Eur Heart J Acute Cardiovasc Care
{Volume}: 13
{Issue}: 7
{Year}: 2024 Jul 24
{Factor}: 4.766
{DOI}: 10.1093/ehjacc/zuae073
{Abstract}: <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.