{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:49:00Z","timestamp":1791470940610,"version":"4.3.4"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:00:00Z","timestamp":1656460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We examined the appropriateness of prehospital cardiac catheter laboratory activation (CCL\u2010A) in ST\u2010segment elevation myocardial infarction (STEMI) utilizing the University of Glasgow algorithm (UGA) and remote interventional cardiologist consultation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The incremental benefit of prehospital electrocardiogram (PH\u2010ECG) transmission on the diagnostic accuracy and appropriateness of CCL\u2010A has been examined in a small number of studies with conflicting results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified consecutive PH\u2010ECG transmissions between June 2, 2010\u00a0and October 6, 2016. Blinded adjudication of ECGs, appropriateness of CCL\u2010A, and index diagnoses were performed using the\u00a0fourth universal definition of MI. The primary outcome was the appropriate CCL\u2010A rate. Secondary outcomes included rates of false\u2010positive CCL\u2010A, inappropriate CCL\u2010A, and inappropriate CCL nonactivation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1088 PH\u2010ECG transmissions, there were 565 (52%) CCL\u2010As and 523 (48%) CCL nonactivations. The appropriate CCL\u2010A rate was 97% (550 of 565 CCL\u2010As), of which 4.9% (<jats:italic>n<\/jats:italic>\u2009=\u200927) were false\u2010positive. The inappropriate CCL\u2010A rate was 2.7% (15 of 565 CCL\u2010As) and the inappropriate CCL nonactivation rate was 3.6% (19 of 523 CCL nonactivations). Reasons for appropriate CCL nonactivation (<jats:italic>n<\/jats:italic>\u2009=\u2009504) included nondiagnostic ST\u2010segment elevation (<jats:italic>n<\/jats:italic>\u2009=\u2009128, 25%), bundle branch block (<jats:italic>n<\/jats:italic>\u2009=\u2009132, 26%), repolarization abnormality (<jats:italic>n<\/jats:italic>\u2009=\u200961, 12%), artefact (<jats:italic>n<\/jats:italic>\u2009=\u200972, 14%), no ischemic symptoms (<jats:italic>n<\/jats:italic>\u2009=\u200932, 6.3%), severe comorbidities (<jats:italic>n<\/jats:italic>\u2009=\u200926, 5.2%), transient ST\u2010segment elevation (<jats:italic>n<\/jats:italic>\u2009=\u200920, 4.0%), and others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PH\u2010ECG interpretation utilizing UGA with interventional cardiologist consultation accurately identified STEMI with low rates of inappropriate and false\u2010positive CCL\u2010As, whereas using UGA alone would have almost doubled CCL\u2010As. The benefits of cardiologist consultation were identifying \u201cmasquerading\u201d\u00a0STEMI and avoiding unnecessary CCL\u2010As.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30300","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T08:59:55Z","timestamp":1656493195000},"page":"295-303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Utility of prehospital electrocardiogram interpretation in ST\u2010segment elevation myocardial infarction utilizing computer interpretation and transmission for interventional cardiologist consultation"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4354-8899","authenticated-orcid":false,"given":"Amir","family":"Faour","sequence":"first","affiliation":[{"name":"Department of Cardiology Liverpool Hospital  Sydney New South Wales Australia"},{"name":"South Western Sydney Clinical School The University of New 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