A-15 | Outcomes of Post-Percutaneous Coronary Intervention Same-Day Discharge of Hospitalized Patients with Non-ST Elevation Myocardial Infarction Versus Unstable Angina

In the setting of rising hospitalization costs, the economic burden of acute coronary syndrome (ACS) has been growing. Same-day discharge (SDD) after elective percutaneous coronary intervention (PCI) has been endorsed by the American College of Cardiology. There is very limited data comparing SDD in inpatient population presenting with Non-ST elevation myocardial infarction (NSTEMI) versus Unstable Angina (UA). A retrospective chart review was conducted of inpatients who underwent PCI and qualified for SDD at our institution between 2017-2023, including inpatients with NSTEMI and UA. Patients were identified and outcomes data was obtained using our electronic medical records system and the National Cardiovascular Data Registry. Primary endpoint was Major Adverse Events (MAE) at 30 days defined as composite of all-cause mortality, ACS, stroke, major bleeding, repeat revascularization. Statistical analysis was performed via SPSS using a general multivariate model and chi-square analysis. P value < 0.05 was considered significant. A total of 205 patients undergoing SDD after PCI, including 141 NSTEMI patients and 64 UA patients, were included in analysis. Radial access was utilized in 122 (87%) NSTEMI patients and 53 (83%) outpatients, p=0.5. More than one stent was placed in 33 (23.4%) NSTEMI patients and 20 (31.3%) UA patients, p=0.2. There was no statistically significant difference in MAE between NSTEMI patients versus UA patients at 30 days, 3 (2.1%) vs. 1 (1.6%), respectively, p = 0.8. For NSTEMI patients and UA patients respectively, ACS occurred in 1 (0.7%) vs. 1 (1.6%) p=0.6 and major bleeding in 2 (1.4%) vs. 0 (0%) p=0.3. No all-cause death, repeat revascularization, or stroke were observed at 30 days. Post-PCI SDD does not appear to be associated with a difference in MAE between NSTEMI and UA. Provided they are selected appropriately, SDD of both NSTEMI and UA patients is feasible and may be done safely.