Lung ultrasound before PCI improves in-hospital management of STEMI patients
Adding lung ultrasound (LUS) to a STEMI patient’s Killip classification leads to a more thorough, effective assessment, according to new findings published in Circulation: Cardiovascular Imaging. This could make a big impact on the in-hospital management of these patients.
Noting that LUS is becoming more and more common in cardiology, and emphasizing the method’s “quickness and simplicity,” the authors assessed the performance of LUS on 215 STEMI patients admitted to a single university hospital from April 2018 to June 2019. LUS was performed by an operator blinded to the patient’s Killip classification before the patient was scheduled to undergo percutaneous coronary intervention (PCI). A LUCK (LUS combined with Killip) classification was then developed.
Overall, the team found that LUCK classifications for in-hospital mortality achieved an area under the ROC curve of 0.89, higher than the Killip classification’s 0.86. When the LUS showed no signs of pulmonary congestion, the negative predictive value for in-hospital mortality was 98.1%.
“In a cohort of patients with STEMI undergoing primary PCI, admission LUS added to Killip classification was feasible and more sensitive than physical examination to identify patients at risk for in-hospital outcomes,” wrote lead author Gustavo N. Araujo, MD, PhD, Hospital de Clínicas de Porto Alegre in Brazil, and colleagues. “Identifying these patients is essential for in-hospital care to select those who may benefit from more intensive monitoring and treatment.”
The full study by Araujo et al. is available here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.