Applicability of the Zwolle score for selection of very high-risk ST-elevation myocardial infarction patients treated with primary angioplasty.

Autor:	Cordero A; Cardiology Department, Hospital Universitario de San Juan Alicante, Spain.; Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Spain.; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain., Cid-Alvarez B; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.; Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain., Monteiro P; Cardiology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal., García-Acuña JM; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.; Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain., Gonçalves F; Cardiology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal., Escribano D; Cardiology Department, Hospital Universitario de San Juan Alicante, Spain.; Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Spain., Trillo R; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.; Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain., Alvarez-Alvarez B; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.; Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain., Gonçalves L; Cardiology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal., Bertomeu-Gonzalez V; Cardiology Department, Hospital Universitario de San Juan Alicante, Spain.; Unidad de Investigación de Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Spain., González-Juanatey JR; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.; Cardiology Department, Complejo Hospital Universitario de Santiago, Santiago de Compostela, Spain.
Jazyk:	angličtina
Zdroj:	Angiology [Angiology] 2024 Feb; Vol. 75 (2), pp. 175-181. Date of Electronic Publication: 2022 Nov 19.
DOI:	10.1177/00033197221139915
Abstrakt:	The Zwolle risk score was designed to stratify in-hospital mortality risk of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI) and for decision-making in the unit where patients are admitted. We assessed the accuracy of Zwolle risk score for in-hospital mortality estimation compared with the GRACE score in all patients (n = 4446) admitted for STEMI in 3 university hospitals. Only one fourth of the patients were classified as high-risk by the Zwolle risk score vs 60% by the GRACE score. In-hospital mortality was 10.6%. A statistically significant increase in in-hospital mortality, adjusted by age, gender, and revascularization, was observed with both scores. The assessment of the optimal cut-off points verified the accuracy of Zwolle score ≥4 as optimal threshold for high-risk categorization. In contrast, GRACE score ≥140 had very low specificity as well as percentage of patients correctly classified; GRACE score ≥175 was fairly better. The reclassification index of the Zwolle score after applying the GRACE score was 35.5%. Selection of high-risk STEMI patients treated with pPCI based on the Zwolle risk score has higher specificity than the GRACE score and might be useful in clinical practice. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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