Prognosis

The risk of dying is increased with complications

• evidence of heart failure ^{a b} particularly cardiogenic shock ^a
  • worsening Killip class ^{a b}
  • reduced ejection fraction ^{a b}
  • reduced LV end diastolic pressure ^a
• increased heart rate ^b
• hypotension ^b
• mitral regurgitation ^b particularly if early ^a

Why?

Heart failure and mitral regurgitation increase the risk of dying

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
first myocardial infarction b	heart failure independent	death at uncertain duration	4.0%	2.47 (1.84 to 3.33)	19 (12 to 32)
myocardial infarction b	Killip class IV v. I independent	death at 4 weeks	5.1%	7.86 (5.88 to 10.49)	4 (3 to 5)
myocardial infarction b	Killip class III v. I independent	death at 4 weeks	5.1%	4.37 (3.34 to 5.71)	7 (5 to 10)
myocardial infarction a	Killip class II or more independent	death at 18 months	4.0%	6.16 (2.01 to 18.83)	6 (3 to 27)
myocardial infarction b	mitral regurgitation independent	death from heart disease at 2 years	12%	2.00 (1.28 to 3.04)	11 (6 to 35)