{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T20:33:46Z","timestamp":1779395626791,"version":"3.53.1"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,2,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The Zwolle Risk Score was designed to identify the risk of complications in patients with ST\u2010segment\u2012elevation myocardial infarction (STEMI) following percutaneous coronary intervention (PCI). Its utility following PCI in STEMI treated with thrombolysis is unknown. The objective was to evaluate the safety of using the Zwolle Risk Score to triage patients with STEMI following PCI, including patients receiving thrombolysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Patients aged \u226518\u00a0years with STEMI and primary PCI or PCI after thrombolysis were included. A triage protocol was developed, with high\u2010risk patients those with Zwolle Risk Score \u22654 triaged to the cardiac intensive care unit. A prospective evaluation of the triaging protocol was performed on 452 patients, mean age 65\u00b112\u00a0years, 73% men. Median Zwolle Risk Score was 3 (interquartile range, 2\u20125), with 257 low\u2010risk (57%), and 195 high\u2010risk (43%) patients. Adherence to the protocol was 91%. In\u2010hospital mortality was 0.4% in low\u2010risk and 13% in high\u2010risk patients (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Seventy\u2010two patients (16%) received thrombolysis. Median time post\u2010thrombolysis to PCI was 281\u00a0minutes (interquartile range, 219\u2012376). In\u2010hospital mortality was 0% versus 9% (\n              <jats:italic>P<\/jats:italic>\n              =0.083) for low\u2010 and high\u2010risk patients, respectively. High\u2010risk patients had higher rates of cardiogenic shock (34% versus 1%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), pulmonary edema (60% versus 9%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), arrhythmia (25% versus 2%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), blood transfusion (10% versus 2%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), and stroke (4% versus 0.4%,\n              <jats:italic>P<\/jats:italic>\n              =0.011). Median hospital costs decreased by $1419 per low\u2010risk patient after protocol implementation.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">For patients with STEMI following primary PCI or PCI following thrombolysis, a Zwolle\u2010based triaging system is safe and may decrease cardiac intensive care unit usage costs.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.024759","type":"journal-article","created":{"date-parts":[[2022,2,8]],"date-time":"2022-02-08T11:30:40Z","timestamp":1644319840000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Using the Zwolle Risk Score at Time of Coronary Angiography to Triage Patients With ST\u2010Elevation Myocardial Infarction Following Primary Percutaneous Coronary Intervention or Thrombolysis"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2452-3327","authenticated-orcid":false,"given":"Christopher J.","family":"Parr","sequence":"first","affiliation":[{"name":"Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences Max Rady College of Medicine, University of Manitoba Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorraine","family":"Avery","sequence":"additional","affiliation":[{"name":"Cardiac Sciences Manitoba St. Boniface Hospital Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Hiebert","sequence":"additional","affiliation":[{"name":"Cardiac Sciences Manitoba St. Boniface Hospital Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8722-0182","authenticated-orcid":false,"given":"Shuangbo","family":"Liu","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences Max Rady College of Medicine, University of Manitoba Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2271-930X","authenticated-orcid":false,"given":"Kunal","family":"Minhas","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences Max Rady College of Medicine, University of Manitoba Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Ducas","sequence":"additional","affiliation":[{"name":"Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences Max Rady 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