The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
Prognostic Assessment of Patients With Acute Myocardial Infarction Treated With Primary Angioplasty: Implications for Early Discharge
Abstract
Background— The aim of this study was to create a practical score for risk stratification in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty and to assess the feasibility of early discharge in low-risk patients. Methods and Results— A prognostic score was built according to 30-day mortality rates in 1791 patients undergoing primary angioplasty for STEMI. For the identified low-risk patients without any contraindication to early discharge, we estimated and compared the costs of conventional care (prolonged 24-hour hospitalization) with the costs of shifting the care from inpatient to outpatient setting (early discharge) between 48 and 72 hours. Independent predictors of 30-day mortality included in the score were age, anterior infarction, Killip class, ischemic time, postprocedural Thrombolysis In Myocardial Infarction (TIMI) flow, and multivessel disease. This score was able to identify a large cohort (73.4%) of low-risk (score ≤3) patients, with a good discriminatory capacity ( c statistic=0.907). The mortality rate was 0.1% at 2 days and 0.2% between 2 and 10 days in patients with a score ≤3. The incremental cost-effectiveness ratio for late discharge in low-risk patients was estimated at 1949.33. Therefore, this policy would save 1 life per 1097 low-risk patients, at additional costs of 194 933.33, in comparison with an early discharge policy. Conclusions— This score is a practical and useful index for risk stratification after primary angioplasty for STEMI, with a significant impact on clinical decision-making and the related costs. It reliably identifies a large group of patients at very low risk, who may safely be discharged early after primary angioplasty.
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2023 ESC Guidelines for the management of acute coronary syndromes
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Metadata
- Authors
- De Luca, G., Suryapranata, H., van’t Hof, A. W. J., de Boer, M.-J., Hoorntje, J. C. A., Dambrink, J.-H. E., Gosselink, A. T. M., Ottervanger, J. P., & Zijlstra, F.
- Venue
- Circulation
- Published
- 2004-06-08
- Volume
- 109
- Issue
- 22
- Pages
- 2737-2743
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2141604880
- Cited by
- 293
- References
- 17
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- closed
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- De Luca, G., Suryapranata, H., van’t Hof, A. W. J., de Boer, M.-J., Hoorntje, J. C. A., Dambrink, J.-H. E., Gosselink, A. T. M., Ottervanger, J. P., & Zijlstra, F. (2004). Prognostic Assessment of Patients With Acute Myocardial Infarction Treated With Primary Angioplasty: Implications for Early Discharge. Circulation. https://doi.org/10.1161/01.cir.0000131765.73959.87
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