Myocardial infarction serves as one of the most common entity among the life-threatening diagnoses in emergency hospital admissions. First few hours are critical as most of the complications occur during that time [10]. With the passage of time, there has been a significant improvement in diagnosis and management of complications of MI [11]. However, Pakistan is a resource limited country with lack of well developed screening programs due to which patients present late, leading to high rate of complications like left ventricular thrombosis [12]. Moreover, frequency of multi-vessel disease even in the absence of ST segment elevation on electrocardiogram is high [13].
Patients belonging to a younger age group (mean age 57 years) have the maximum burden of CHD. Our age range was 43–70 years showing a need of extensive preventing program that can lead to decrease in young age mortality in our patients at risk of coronary artery disease. Majority of the patients were male.
Frequency of patients with post MI failure decreased from Killip class I-IV. 395 (81.4%) individuals fell in Killip class I while 46(9.5%) in killip class II 27(5.6%) in killip class III and 17(3.5%) in killip class IV. 85% (17.5%) died during their stay in hospital. It is quite high as compared to developed nations; owing to delayed presentation and poor patient compliance.
Our results showed that diabetes and smoking were significantly associated with MI. Coronary heart disease was common among obese patients as our study depicted that 44.7% had their BMI > 30 kg/m2. Killip class significantly determined increased mortality in our sampled population.
Our results are concordant with the published literature. Mello BH et al [14] conducted a study in Brazil where they evaluated 1906 patients with documented MI with a mean follow up of 5 years for the assessment of mortality. They developed Kaplan-Meier (KM) curves for comparison between survival distributions according to Killip class. Their results showed that the Killip classification played a relevant prognostic role in mortality at mean follow-up of 5 years post-MI. Similarly, a study conducted by Khot et al [15] also showed that higher Killip class is associated with higher mortality at 30 days.
Therefore, Killip classification has proven to be a good reliable and valid tool for early risk stratification of MI patients. Almost 100% mortality was found in Killip class IV in our study. Presence of diabetes, smoking and obesity increase the likelihood of increased risk and higher killip class as shown by our results.