Natriuretic peptides in addition to Zwolle score to enhance safe and early discharge after acute myocardial infarction: A prospective observational cohort study

Ganovská, Eva; Arrigo, Mattia; Helánová, Kateřina; Littnerová, Simona; Sadoune, Malha; Kuběna, Petr; Pavlušová, Marie; Jarkovský, Jiří; Gottwaldová, Jana; Kala, Petr; Dastych, Milan; Ishihara, Shiro; Aelst, Lucas Van; Cohen‐Solal, Alain; Gayat, Étienne; Špinar, Jindřich; Pařenica, Jiří; Mebazaa, Alexandre

doi:10.1016/j.ijcard.2016.04.148

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…The ZRS has been validated in several studies and can be used in up to 60% of all STEMI patients. 11,22,23 In this metaanalysis, the study by Melberg et al 13 and the EDAMI trial used the ZRS to identify low-risk STEMI patients (ZRS 3). The PAMI-II criteria designate as low-risk STEMI patients aged 70 years or less, with a left ventricular ejection fraction greater than 45%, one or twovessel disease, successful PCI and no persistent arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

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Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials

Gong

et al. 2018

Eur J Prev Cardiolog

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Background Early discharge after successful primary angioplasty is common, but the evidence supporting the practice is still lacking. We therefore performed a meta-analysis assessing the safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction (STEMI). Methods Randomised controlled trials were identified and extracted from PubMed, Embase, Cochrane Library databases and reference lists of relevant papers. Heterogeneity was analysed using the I test. If there was a lack of heterogeneity, fixed effects models would be used for the meta-analysis, otherwise random effects models were used. Statistical analyses were performed using Review Manager 5.3. Results Five randomised controlled trials involving 1575 STEMI patients met the criteria. Meta-analysis showed that the early discharge strategy group had a significantly shortened length of hospital stay compared to the conventional discharge strategy group (standardised mean difference -1.46, 95% confidence interval (CI) -2.04 to -0.88; P < 0.0001), and there was no difference in mortality and readmission rates between the two groups (risk ratio 0.78, 95% CI 0.50 to 1.22; P = 0.41). Conclusions The findings of this meta-analysis suggested that the early discharge strategy after successful primary angioplasty is safe among selected low-risk STEMI patients. A shorter hospital stay could benefit both the patients and the healthcare systems.

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Section: Discussionmentioning

confidence: 99%

“…The ZRS has been validated in several studies and can be used in up to 60% of all STEMI patients. 11,22,23 In this meta-analysis, the study by Melberg et al. 13 and the EDAMI trial used the ZRS to identify low-risk STEMI patients (ZRS ≤ 3).…”

Section: Discussionmentioning

confidence: 99%

Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials

Gong

et al. 2018

Eur J Prev Cardiolog

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“…Different factors have been validated in different studies as markers of clinical outcomes in terms of mortality post STEMI including age, mode of treatment, time to start treatment, prior history of diabetes, renal and coronary artery disease together with number of diseased vessels, brain natriuretic peptide (BNP) levels, LVEF, and presence of complications like major bleeding, cardiac arrest, shock and heart failure [14-22]. The post-primary PCI in-hospital 30-day mortality has a variation between different studies around 2 % to 8% irrespective of the risk of the patient population among European countries [23].…”

Section: Discussionmentioning

confidence: 99%

Left Ventricular Ejection Fraction along with Zwolle Risk Score for Risk Stratification to Enhance Safe and Early Discharge in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Retrospective Observational Study

Banga

Gumm

Kizhakekuttu

et al. 2019

Cureus

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IntroductionZwolle risk score (ZRS) is a validated scoring system to determine the time of discharge in ST-segment elevation myocardial infarction (STEMI) patients. Left ventricular ejection fraction (LVEF) also provides prognostic information after ST-elevation myocardial infarction (STEMI). We studied that the addition of LVEF to ZRS variable can improve decision making in safe and early discharge in STEMI patients post-primary coronary intervention.MethodsOverall, 249 STEMI patients were studied retrospectively. LVEF was considered as an independent variable. The patients having LVEF <50% were under Group A and LVEF ≥50% were under Group B. Groups were analyzed by model comparison for overall hospital length of stay (LOS) and Intensive care unit (ICU) LOS post-primary percutaneous coronary intervention (PCI).ResultsThere were 123 patients in Group A and 126 patients in Group B. Comparison for primary outcomes showed significant difference with hospital length of stay (LOS) being 3.1 ± 2.3 days in Group A versus 2.1 ± 0.8 days in Group B (p < 0.001). Similarly, ICU stay was also significantly higher in Group A with 36.5 ± 31.4 hours versus 24.0 ± 11.8 hours for Group B, which led to prolonged hospitalization for patients with LVEF <50%. Model 1 that considers ZRS individually is nested within Model 2 where ZRS and LVEF are considered together. The profile log-likelihood ratio test favors model 2 over model 1 (p < 0.0001). Similarly for ICU LOS, R2 = 0.12 (Model 1) < R2 = 0.20 (Model 2). The F test favors model 2 over model 1 (p < 0.0001).ConclusionWe concluded that adding LVEF to Zwolle risk score gives a better model for risk stratification in STEMI patients to decide early and safe discharge post-primary PCI.

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“…Показано, что данные факторы являются независимыми предикторами 30-дневной смертности. Пациенты с ≤3 баллами по шкале Zwolle имеют 0,5% риск 30-дневной смертности и могут быть безопасно выписаны из стационара в первые 72 ч. Валидность шкалы Zwolle была показана в целом ряде исследований [295][296][297][298].…”

Section: показания к выписке пациента из стационараunclassified

2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction

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2020

Russ J Cardiol

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Natriuretic peptides in addition to Zwolle score to enhance safe and early discharge after acute myocardial infarction: A prospective observational cohort study

Cited by 10 publications

References 19 publications

Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials

Safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction: A meta-analysis of randomised controlled trials

Left Ventricular Ejection Fraction along with Zwolle Risk Score for Risk Stratification to Enhance Safe and Early Discharge in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention: A Retrospective Observational Study

2020 Clinical practice guidelines for Acute ST-segment elevation myocardial infarction

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