Prognostic role and predictors of high Killip class in myocardial infarction with non-obstructive coronary artery

Abstract Background Killip classification is a simple clinical tool for risk stratification in patients with acute myocardial infarction (AMI). However, predictors of high class at admission and its prognostic role non-obstructive coronary artery (MINOCA) are still poorly explored. Purpose To identify potential MINOCA compared to obstructive (MIOCA). Methods We included AMI undergoing angiogram from January 2016 June 2021. were defined according the current European guidelines criteria. classes those MIOCA if greater than 1. Kaplan-Meier (KM) curves developed comparison all-cause mortality among (>1) others. Multivariate logistic regression analysis was used determine class. Results Among 3261 AMI, 261 MINOCA. The median follow-up time 36.1±15.2 months. >1 occurred 24 (8.8%) 518 (17.3%) cases (p=0.001). During long-term follow-up, associated 3-fold increased both populations (p<0.001 p=0.001). Furthermore, groups, KM survival significantly worse lower (p<0.001). Within multivariate showed that older age [OR 1.04, 95% CI (1.03–1.06), p<0.001], diabetes 1.60, (1.24–2.07), ST-segment-elevation 1.53, (1.12–2.10), p=0.008], left ventricular ejection fraction (LVEF) 0.95, (0.94–0.96), p<0.001] elevated cardiac troponin 1.01, (1.00–1.01), p=0.01]. Instead, only 1.08, (1.03–1.14), p=0.003], 7.40, (1.08–50.65), p=0.04] 3.60, (1.09–11.96), whereas LVEF (p=0.3) (p=0.6) exhibited neutral impact these patients. Conclusions High high-risk marker adverse cardiovascular events even Simple baseline characteristics (such as age, diabetes, ST-segment-elevation) predict subjects can help population who might benefit stricter management. identified but they did not show similar setting This may reflect different pathogenesis damage extent MIOCA. Funding Acknowledgement Type funding sources: None.