Validation of the Zwolle Risk Score in STEMI Patients Undergoing Primary PCI: Insights from the ISCAS-STEMI COVID-19 Registry
Rattachement africain : it, Égypte, tr, br, ru, mk, si, dk, sg, ro, es, pl, nl, cz, us, cn, hk, id, hr, gr, fr, tw, pt, ar, de, fi, co, uy, Algérie, be. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Several scores have been developed to facilitate risk stratification and early discharge following primary angioplasty, particularly the Zwolle Risk Score (ZRS). However, validation in large-sized studies is still lacking. Therefore, the aim of the current study was to validate the use of the ZRS in a contemporary global population, including patients who were treated during the SARS-CoV-2 pandemic and enrolled in a large intercontinental observational study. METHODS: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving primary PCI centers from Europe, Latin America, South-East Asia, and NorthAfrica, including patients treated from March 1st until June 30th, in 2019 and 2020]. ZRS was calculated for each patient. The patients were additionally categorized according to the following values of the ZRS [≤3; 4-6; 7-9; ≥10]. Our study outcomes were in-hospital and 30-day mortality. The discriminatory capacity of the ZRS was assessed by the area under the ROC curve [c statistic] as an index of model performance. RESULTS: Our population is represented by 16084 STEMI patients undergoing mechanical reperfusion enrolled in 109 centers. The score showed a very good performance in the predicting mortality both in-hospital [AUC=0.83 [0.82-0.85], p<0.0001] and at 30- day follow-up [AUC=0.82 [0.81-0.84, p<0.0001]. The results were confirmed when the ZRS was separately applied to patients treated in 2019 and 2020, with good stability across time. ZRS was able to identify a large cohort [n=10672, 66.3%] of low-risk patients [score ≤3] with a very low mortality rate at 2 days [1%] and between 3 and 10 days [0.7%], with a very good negative predictive value for in-hospital [98.3%] and 30-day mortality [97.7%], with similar results in 2019 and 2020. CONCLUSION: This study is the first to demonstrate the good prognostic performance of the ZRS in a large-scale contemporary global multicenter validation set. Similar results were obtained both in the pre-pandemic and the COVID-19 era. ZRS ≤3 identified a very low-risk population that could be discharged early, even during the COVID-19 pandemic, with expected advantages in the availability of hospital beds and nursing staff, costs of medical care, and in-hospital risk of contagion.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Validation of the Zwolle Risk Score in STEMI Patients Undergoing Primary PCI: Insights from the ISCAS-STEMI COVID-19 Registry
- Date Crossref
- 01/01/2026
- Éditeur
- Bentham Science Publishers Ltd.
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Messina AOU Policlinico G Martino pays non établi dans la noticeUniversité ou école supérieure
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Istituto Clinico Sant'Ambrogio pays non établi dans la noticeÉtablissement de santé
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Azienda Ospedaliera Universitaria Policlinico "G. Martino" pays non établi dans la noticeÉtablissement de santé
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Assiut University Hospitals Assiut University Hospitals, Égypte (code pays fourni par la source)Université ou école supérieure
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Assiut University Division of Cardiology Assiut University, Égypte (code pays fourni par la source)Université ou école supérieure
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Bursa City Hospital Division of Cardiology pays non établi dans la noticeÉtablissement de santé
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Universidade Federal de Pernambuco pays non établi dans la noticeUniversité ou école supérieure
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Kemerovo State University pays non établi dans la noticeUniversité ou école supérieure
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Ss. Cyril and Methodius University in Skopje pays non établi dans la noticeUniversité ou école supérieure
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Ljubljana University Medical Centre Centre for Intensive Internal Medicine pays non établi dans la noticeÉtablissement de santé
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Odense University Hospital pays non établi dans la noticeOrganisme public
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National University Hospital Department of Cardiology pays non établi dans la noticeÉtablissement de santé
AOU Policlinico G Martino — University of Messina, Istituto Clinico Sant'Ambrogio et Azienda Ospedaliera Universitaria Policlinico "G. Martino", avec 9 autres affiliations. Pays d’affiliation : Égypte, Algérie.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.