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Topic: Killip class

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	Killip class - Wikipedia, the free encyclopedia
		Individuals with a low Killip class are less likely to die within the first 30 days after their myocardial infarction than individuals with a high killip class.
		Killip class III describes individuals with frank pulmonary edema.
		Killip class IV describes individuals in cardiogenic shock.
	en.wikipedia.org /wiki/Killip_class (151 words)

	Physical Examination in Acute Coronary Syndromes - June 1, 2004 - American Family Physician
		Killip class I patients were those without heart failure; class II patients had mild heart failure with rales involving one third or less of the posterior lung fields and systolic blood pressure of 90 mm Hg or higher.
		Class IV patients were those in cardiogenic shock with any rales and systolic blood pressure less than 90 mm Hg, but because there were few of these patients, class III and class IV patients were combined for the purposes of this study.
		Higher Killip classification was a powerful predictor of all-cause mortality: Killip class II was associated with an increase of more than threefold in 30-day mortality, and Killip class III or IV was associated with an increase of more than fivefold for the same period.
	www.aafp.org /afp/20040601/tips/3.html (552 words)

	Heart failure - Wikipedia, the free encyclopedia (via CobWeb/3.1 planetlab2.cs.umd.edu) (Site not responding. Last check: 2007-10-14)
		The NYHA functional class is a commonly used way to gauge the progression of CHF in a particular patient.
		Patients with NYHA class III or IV, left ventricular ejection fraction (LVEF) of 35% or less and a QRS interval of 120 ms or more may benefit from cardiac resynchronization therapy (CRT; pacing both the left and right ventricles), through implantation of an bi-ventricular pacemaker, or surgical remodelling of the heart.
		Patients with NYHA class II, III or IV, and LVEF of 35% (without a QRS requirement) may also benefit from an implantable cardioverter-defibrillator (ICD), a device that is proven to reduce all cause mortality by 23% compared to placebo.
	en.wikipedia.org.cob-web.org:8888 /wiki/Congestive_heart_failure (2051 words)

	Improved Survival after Acute Myocardial Infarction in Patients with Advanced Killip Class (Site not responding. Last check: 2007-10-14)
		Increases in in-hospital mortality and prevalence of in-hospital complications correspond significantly with advanced Killip class (p<0.01), with in-hospital mortality 7% in class I, 17.6% in classes II/III, and 36% in class IV patients (p<0.001).
		Killip classification was strongly associated with mode of therapy administered within 24 h of admission (p<0.01).
		Conclusions: Killip classification remains a strong independent predictor of in-hospital mortality and complications, and of long-term survival.
	www.clinicalcardiology.org /productcart/pc/briefs/200010briefs/cc23-751.html (326 words)

	Myocardial infarction: Killip class measured severity of heart failure. (Site not responding. Last check: 2007-10-14)
		Killip class measured the severity of heart failure with myocardial infarction.
		Worsening Killip class has been found to be independently associated with increasing mortality in several studies.
		Killip T, and Kimball JT: Treatment of myocardial infarction in a coronary care unit: a two year experience of 250 patients.
	www.eboncall.org /CATs/1390.htm (143 words)

	The Cleveland Clinic Press Room
		Killip classification grades the severity of acute and chronic heart failure by assigning the failure a level of I to IV, with I indicating no evidence of heart failure and IV indicating cardiogenic shock in which the heart is unable to supply sufficient blood to the body.
		Class II patients (some evidence of heart failure) were at three times greater risk of dying within 30 days than were Class I patients.
		Patients in Class III (pulmonary edema) and Class IV (cardiogenic shock) were at more than five times greater risk of dying within 30 days than were their Class I counterparts.
	www.clevelandclinic.org /media/release.asp?Press_Releases_No=392 (599 words)

	Killip
		Effect on survival of acute myocardial infarction in Killip classes II or III patients undergoing invasive coronary...
		Killip Class in Admission and Dilatation After MI Early identification of patients in whom left ventricular dilatation is likely to occur may have important therapeutic implications.
		Thus the purpose of this study was to evaluate the relation between Killip class on admission and subsequent left...
	classiii.mintclass.com /killip (938 words)

	Dual Language Program (Site not responding. Last check: 2007-10-14)
		The mission of the Killip Dual Language Program is to provide students with an education that develops fluency and literacy in two languages (Spanish and English), while maintaining high academic standards.
		Initiated in the year 1996 with the first class, a group of kindergarteners, the program has added a grade level each year, with the first class now in the fourth grade.
		The classes ideally have 50% Native Spanish speakers and 50% Native English speakers, with some variation to accommodate the needs of that grade level.
	www.flagstaff.k12.az.us /killip/programs/duallanguage.htm (223 words)

	[No title]
		WILFRED KILLIP: Okay, as you approach the campus from the Sitgreaves, or Old 66, and from the south was the building that is now used, I think, as a journalism building, was the Training School.
		Classes were very much similar to that in the building at that time.
		The average load in those classes was in the neighborhood of the thirties to forties, and it was departmentalized.
	www.nau.edu /library/speccoll/images/text/txt/38213.htm (9377 words)

	ACC: Eplerenone Role in Post-Myocardial Infarction Patients with Mild Heart Failure Confirmed (Site not responding. Last check: 2007-10-14)
		In the present trial, his team determined the effect on mortality and morbidity of eplerenone used with standard therapy in patients with Killip class II or III heart failure based on an analysis of EPHESUS subjects.
		The 4,277 patients had heart failure that was classified as Killip class II (patients had crackles, S3 gallop and elevated jugular venous pressure), and 1095 were Killip class III (frank pulmonary oedema).
		Compared with those categorized as Killip class I (no clinical signs of heart failure), the risk of all-cause mortality among those in Killip class II or III was increased by 61%, CV mortality /CV hospitalization by 42%, CV mortality by 69%, CV hospitalization by 41%, and sudden cardiac death by 52%.
	www.pslgroup.com /dg/24B112.htm (649 words)

	Editor's Note: Determining Prognosis after Acute Myocardial Infarction (Site not responding. Last check: 2007-10-14)
		Thirty-three years ago Killip and Kimball developed a simple prognosis classification based on the presence or absence of heart failure for patients with myocardial infarction (MI).
		As most of you will recall, Class I was characterized by the absence of rales over the lung fields and the absence of a third heart sound, Class II by the presence of rales over 50% or less of the lung fields or the presence of a third heart sound.
		Class III was characterized by rales over more than 50% of the lung fields, with the patient often presenting in pulmonary edema.
	www.clinicalcardiology.org /productcart/pc/briefs/200102briefs/cc24-94.editorsnote.html (934 words)

	Full text: Trends in the Proportion of Patients Younger than 75 Years with Acute Myocardial Infarction and Killip Class ...
		Acute pulmonary edema (Killip III) or cardiogenic shock (Killip IV) is associated with a higher mortality in the acute phase of myocardial infarction (AMI).
		In the subgroup of patients who presented with a Killip classification of III to IV, the mortality rate at 28 days was greater in older patients, patients with a history of angina, and patients who presented with serious ventricular arrhythmias (Table 4).
		The presence of Killip classification III or IV during the acute phase of a myocardial infarct is associated with an increased mortality rate (30.5% and 79.5%, respectively; 51.7% overall).
	www.revespcardiol.org /cgi-bin/wdbcgi.exe/cardio/cardioeng.mrevista_cardio.go?pident=13042536 (5252 words)

	Physical examination in acute coronary syndromes American Family Physician - Find Articles
		In this regard, the usefulness of the Killip classification has been established in the context of sinus tachycardia (ST)-elevation myocardial infarction, but it is less well studied with non--ST-elevation acute coronary syndromes.
		The authors conclude that Killip classification is a powerful independent predictor of all-cause mortality in patients with non--ST-elevation acute coronary syndromes.
		Five factors--age, Killip classification, heart rate, systolic blood pressure, and ST-segment depression on electrocardiography--provide more than 70 percent of the prognostic information for 30-day and six-month mortality in these patients.
	www.findarticles.com /p/articles/mi_m3225/is_11_69/ai_n6076531 (517 words)

	Practical Pointers - OCTOBER 2003
		Killip I—no evidence of HF Killip II—mild HF, with rales involving 1/3 or less of the posterior lung fields and a systolic BP 90 mm or higher.
		Killip I—no evidence of HF Killip II—mild HF, with rales involving 1/3 or less of the posterior lung fields and a systolic BP 90 mm HG or higher.
		Killip II, III, and IV constituted 11% of the overall population, was associated with 30% of deaths.
	www.practicalpointers.org /2003/oct2003.html (11045 words)

	Practice Guidelines - November 15, 2004 - American Family Physician
		Class IIa: It is reasonable to perform procedure or administer treatment (additional studies with focused objectives needed).
		Class IIb: Procedure or treatment may be considered (additional studies with broad objectives needed; additional registry data would be helpful).
		Class III: Procedure or treatment should not be performed or administered because it is not helpful and may be harmful (no additional studies needed).
	www.aafp.org /afp/20041115/practice.html (4662 words)

	Sex-Related Differences in Outcome After ST-Segment Elevation (Site not responding. Last check: 2007-10-14)
		Several studies have found that among patients with STEMI treated by thrombolysis, female sex is associated with a worse outcome, and it is mainly related to a higher incidence of diabetes, more advanced age, and Killip class at presentation, in comparison with men.
		Furthermore, female sex was associated with more advanced Killip class at presentation, despite the lower incidence of previous infarction and anterior infarction location.
		The more advanced Killip class at presentation may be a major explanation for the significantly higher in-hospital mortality rate observed in women.
	www.arabmedmag.com /issue-30-04-2005/cardiology/main05.htm (2282 words)

	DB’s Medical Rants » Blog Archive » Remembering the Killip Classes (Site not responding. Last check: 2007-10-14)
		The Killip classification, a measure of heart failure severity based on physical examination, is a strong predictor of mortality in patients with non-ST-elevation acute coronary syndromes, new research shows.
		Compared with Killip class I patients, class II and class III/IV patients were older and had higher rates of diabetes, prior MI, ST depression, elevated cardiac enzymes, the authors note.
		Mortality at both follow-up points was directly related to the patient’s Killip class at initial presentation, the researchers state.
	medrants.com /index.php/archives/1549 (704 words)

	Late breaking clinical trials: COMMIT/CCS-2 results show enhanced antiplatelet therapy benefits and role for metoprolol ...
		Metoprolol was given as a 15 mg IV dose - administered in three doses over a period of 15 minutes -followed by 50 mg metoprolol tartrate orally every 6 hours, and from the third day, metoprolol succinate 200 mg once-daily as oral dose for the duration of the hospital stay.
		Professor Collins reported that, although the addition of metoprolol significantly reduced the relative risk of re-infarction and ventricular fibrillation (VF) by 18% and 17% respectively, a notable and significant 30% increase in the relative risk of cardiogenic shock (chiefly during the first day or so of treatment) was observed.
		Indeed, metoprolol-treated patients in Killip class III had a 16.2% risk of cardiogenic shock, while those in Killip class II had a 7.9% risk.
	www.seloken.com /3430_46980.aspx?l1=&l2=&mid= (805 words)

	NGC - NGC Summary
		PCI is reasonable in patients with asymptomatic ischemia or CCS class I or II angina and with 1 or more significant lesions in 1 or 2 coronary arteries suitable for PCI with a high likelihood of success and a low risk of morbidity and mortality.
		Class I: Conditions for which there is evidence for and/or general agreement that a given procedure or treatment is beneficial, useful, and effective.
		Class III: Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective, and in some cases may be harmful.
	www.guideline.gov /summary/summary.aspx?doc_id=8343&nbr=4670 (6827 words)

	Evidence-Based On-Call
		ejection fraction, functional class, non ischaemic heart disease and frequency of ventricular fibrillation increase risk of death.
		LV dysfunction: mitral regurgitation, hypertension and worsening ejection fraction increased the risk of dying.
		worsening Killip class and increasing age increased the risk of dying.
	www.eboncall.org /JSP/CATbank/heart%20failure%20CATbank/CHF-CATprognosis.html (261 words)

	CardioExchange - The Website for Cardiovascular Researchers and Clinicians
		The 30-day mortality rate for Killip class I or II VSD patients was 27%; all Killip class III or IV VSD patients died within 30 days.
		Other baseline characteristics, such as hypertension, Killip class, survival time from onset of AMI, and cause of death were not significantly different between the two groups.
		More shock patients had experienced prior infarctions, were classified as Killip classes II and III and presented with lower systemic blood pressure and higher heart rates than nonshock patients.
	www.cardioexchange.com /index.php?page=issue10.html (5076 words)

	Heart failure on admission and the risk of stroke following acute myocardial infarction: the VALIANT registry -- ...
		Class I (OR 1.66, 95% CI 0.86–3.19), whereas Killip Class
		Class and the occurrence of stroke in a general population with
		Class was a predictor of subsequent in-hospital stroke in one
	eurheartj.oxfordjournals.org /cgi/content/full/26/20/2114 (2895 words)

	Myocardial infarction: age over 70, cardiac arrest, Killip class and anterior MI increased the risk of dying following ...
		Patients were at increased risk of dying with a ventricular arrhythmia less than 6 weeks after MI if they were over 70 years old, had a cardiac arrest, were in Killip class III or IV or had an anterior MI.
		Killip class III or IV during the semiacute phase of infarction
		The first two drugs were preferably class I antiarrhythmic drugs, such as procainamide, quinidine, disopyramide, flecainide and propafenone.
	www.eboncall.org /CATs/487.htm (417 words)

	Coronary Palmaz-Schatz stent implantation in acute myocardial infarction [see comments]
		10 of 14 patients with symptoms of Killip class IV on admission were discharged from hospital alive.
		Three of the 66 patients with symptoms of Killip classes I-III died in hospital.
		In patients with symptoms of Killip classes I to III the risk of subacute reocclusion is comparable to that of bail-out stenting after elective balloon angioplasty.
	www.planethydrogen.com /disp_content.asp?obj_id=5237&page=1&search=&meshtext=&author=NEUMANN+FJ&meeting=&startyear=&endyear=&searchtype=SIMPLE (271 words)

	Arquivos Brasileiros de Cardiologia - Primary coronary angioplasty and stent implantation in acute myocardial ... (Site not responding. Last check: 2007-10-14)
		The greatest benefit regarding reduction in mortality was observed when this event was analyzed taking into consideration the Killip class on hospital admission (table IV).
		In the group of patients in Killip III/IV class, 15% of this series, mortality was reduced by 40% with stenting (coronary angioplasty = 32.5% vs stenting = 19.5%, p = 0.02).
		However, the highest benefit with stenting was established in the high-risk subgroups, the mortality rate was reduced in Killip III/IV class patients, treatment of infarctions related to the anterior descending artery and of segmentary obstructive coronary lesions (>10mm).
	www.scielo.br /scielo.php?script=sci_arttext&pid=S0066-782X1999001200002&lng=es&nrm=iso&tlng=en (2705 words)

	JAMA -- Abstract: Prognostic Importance of Physical Examination for Heart Failure in Non-ST-Elevation Acute Coronary ...
		the prognostic importance of Killip classification in non–ST-elevation
		Results Patients in Killip class II (n = 2513) and III/IV (n = 390) were older than those in Killip class I (n = 23 187),
		Higher Killip class was associated with higher mortality at
	jama.ama-assn.org /cgi/content/abstract/290/16/2174 (567 words)

	Killip and Forrester Classifications : Should They Be Abandoned, Kept, Reevaluated, or Modified? -- Madias 117 (5): ...
		to the same class by both the clinical and hemodynamic assessment.
		In contemplating the Killip and Forrester classifications, one
		Killip, T, Kimball, J (1967) Treatment of myocardial infarction in a coronary care unit: a two year experience with 250 patients.
	www.chestjournal.org /cgi/content/full/117/5/1223 (2265 words)

	Process and Outcome of Care for Acute Myocardial Infarction among Medicare Beneficiaries in Connecticut: A Quality ...
		class [9] as a measure of severity of acute myocardial infarction.
		Killip class was selected by the panel as a method for clinical
		in the high-risk Killip classes, one hospital was a lower-mortality
	www.annals.org /cgi/content/full/122/12/928 (5112 words)

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