Admission Bedside Lung Ultrasound Reclassifies Mortality Prediction in Patients With ST-Segment-Elevation Myocardial Infarction

Circulation. Cardiovascular Imaging
Gustavo N AraujoMarco V Wainstein

Abstract

Early risk stratification is essential for in-hospital management of ST-segment-elevation myocardial infarction. Acute heart failure confers a worse prognosis, and although lung ultrasound (LUS) is recommended as a first-line test to assess pulmonary congestion, it has never been tested in this setting. Our aim was to evaluate the prognostic ability of admission LUS in patients with ST-segment-elevation myocardial infarction. LUS protocol consisted of 8 scanning zones and was performed before primary percutaneous coronary intervention by an operator blinded to Killip classification. A LUS combined with Killip (LUCK) classification was developed. Receiver operating characteristic and net reclassification improvement analyses were performed to compare LUCK and Killip classifications. We prospectively investigated 215 patients admitted with ST-segment-elevation myocardial infarction between April 2018 and June 2019. Absence of pulmonary congestion detected by LUS implied a negative predictive value for in-hospital mortality of 98.1% (93.1-99.5%). The area under the receiver operating characteristic curve of the LUCK classification for in-hospital mortality was 0.89 (P=0.001), and of the Killip classification was 0.86 (P<0.001; P=0...Continue Reading

References

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Jun 21, 2019·European Journal of Heart Failure·Elke PlatzUNKNOWN Study Group on Acute Heart Failure of the Acute Cardiovascular Care Association and the Heart Failure Association of the Eur

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Citations

Jun 17, 2020·Circulation. Cardiovascular Imaging·Victor G Dávila-Román, William Checkley
Jan 21, 2021·Medicina·Eftihia PolyzogopoulouJohn Parissis
Mar 15, 2021·Indian Heart Journal·Jorge I ParrasEduardo R Perna

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