ArticleCirculation. Cardiovascular quality and outcomes2018
Value-Based ST-Segment-Elevation Myocardial Infarction Care Using Risk-Guided Triage and Early Discharge.
Article in Circulation. Cardiovascular quality and outcomes, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Value-Based Healthcare Initiatives in Practice: A Systematic Review.Journal of healthcare management / American College of Healthcare Executives · 2021Pooled it
- Early vs Late Discharge in Low-Risk ST-Elevation Myocardial Infarction Patients Treated With Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.Cardiovascular revascularization medicine : including molecular interventions · 2020Pooled it
- Management of Acute Myocardial Infarction During the COVID-19 Pandemic: A Position Statement From the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP).Journal of the American College of Cardiology · 2020Guideline
- Safety and Cost Implications of General Ward versus Coronary Care Unit Admission After PCI for Stable STEMI: A Propensity-Matched Analysis.International journal of general medicine · 2026Article
- Validation of the Zwolle Risk Score in STEMI Patients Undergoing Primary PCI: Insights from the ISCAS-STEMI COVID-19 Registry.Current vascular pharmacology · 2026Observational
- Global Adoption of Value-Based Health Care Initiatives Within Health Systems: A Scoping Review.JAMA health forum · 2025Article
- Characterizing pre-discharge interventions to reduce length of stay for older adults: A scoping review.PloS one · 2025Article
- Factors associated with critical care needs in patients presenting with ST-elevation myocardial infarction: impact of early decompensation and culprit lesions.Frontiers in cardiovascular medicine · 2025Article
- Does value-based healthcare support patient-centred care? A scoping review of the evidence.BMJ open · 2023Article
- Review
- Incidence and Predictors of Adverse Events Among Initially Stable ST-Elevation Myocardial Infarction Patients Following Primary Percutaneous Coronary Intervention.Journal of the American Heart Association · 2022Article
- Using the Zwolle Risk Score at Time of Coronary Angiography to Triage Patients With ST-Elevation Myocardial Infarction Following Primary Percutaneous Coronary Intervention or Thrombolysis.Journal of the American Heart Association · 2022Article
- Safe Triage of STEMI Patients to General Telemetry Units After Successful Primary Percutaneous Coronary Intervention.Mayo Clinic proceedings. Innovations, quality & outcomes · 2021Article
- Adapting STEMI care for the COVID-19 pandemic: The case for low-risk STEMI triage and early discharge.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2021Review
- Clinical Implementation of Predictive Models Embedded within Electronic Health Record Systems: A Systematic Review.Informatics (MDPI) · 2020Article
- Usefulness of the Quick-Sepsis Organ Failure Assessment Score in Cardiovascular Intensive Care Unit to Predict Prognosis in Acute Coronary Syndrome.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundPrior studies suggest that low-risk ST-segment-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention can be considered for early discharge. We describe the implementation of an STEMI risk score to decrease cost while maintaining optimal patient outcomes. METHODS AND
resultsWe determined the impact of risk-guided STEMI care on healthcare value through the retrospective application of the Zwolle Risk Score to 967 patients receiving primary percutaneous coronary intervention between 2009 and 2011. Of these patients, 540 (56%) were categorized as low risk, indicating they may be safely triaged directly to a telemetry unit rather than the intensive care unit and targeted for early discharge. We subsequently developed and implemented a modified Zwolle Risk Calculator into the electronic medical record to support application of the fast-track protocol for low-risk STEMI patients. Among 549 prospective patients with STEMI, 62% were low risk, and the fast-track protocol was followed in 75% of cases. Prospective results confirmed lower rates of complications (low risk 8.3% versus high risk 38.7%;
conclusionsIn our study, risk-guided triage and discharge after primary percutaneous coronary intervention for STEMI improved healthcare value by reducing costs of care without compromising quality of care or patient outcomes.
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