Meilutytė-Lukauskienė, Diana

Objectives: This study explores literature and clinical data related to AMI, focusing on the Killip classification. It includes dataset curation, feature analysis, and a critical evaluation of clinical applicability.

Methods: A systematic review of 37 studies and statistical analysis of anonymised data from 288 MI patients at LSMU Hospital in Kaunas were conducted. The dataset included key risk factors, Killip class, and mortality. Statistical tests (Chi-square, Kruskal–Wallis, Mann–Whitney U, ROC) were used to examine associations and predictive values.

Results: Killip class was significantly associated with age, reduced ejection fraction, troponin levels, and mortality. Class IV patients showed the poorest outcomes. Modifiable risk factors such as hypertension, dyslipidaemia, and smoking were prevalent across all classes. Smoking decreased with clinical severity, and conduction disorders and atrial fibrillation increased. Posterior MI was more frequent in lower classes, while anterior/inferior MI showed no significant trend. While generally increased BMI values were recorded, no significant BMI differences among classes were observed. A higher proportion of women appeared in advanced classes.

Discussion: Higher Killip classes indicate more severe myocardial damage and higher mortality risk. Risk factors like smoking and conduction disturbances varied across classes, while hypertension and dyslipidaemia were consistently prevalent. Posterior MI had a weak class association; infarct extent via troponin was a more reliable severity marker. Gender differences were also observed.

Conclusion: Killip classification remains a strong and simple prognostic tool for post-MI risk stratification, correlating well with mortality and key clinical variables, even in the modern treatment era.