Why the study?
While early interventions have reduced acute myocardial infarction mortality and some studies showed no outcome differences between early and late discharge, the impact of discharge timing on major events in acute STEMI patients required further investigation.
Does early discharge (within 48 hours) compared to late discharge affect the frequency of major cardiovascular events in patients with acute STEMI?
Does early discharge (within 48 hours) compared to late discharge affect the frequency of major cardiovascular events in patients with acute STEMI?
Early discharge within 48 hours for uncomplicated STEMI patients does not significantly increase the risk of major cardiovascular events at 6 months compared to later discharge.
Aim:The mortality rates related to acute myocardial infarction have significantly decreased recently due to early-period cardiovascular interventions. Some studies have shown that there is no difference in cardiovascular outcomes between the early discharge and the late one. In this study, we planned to investigate the effects of early and late discharge on the frequency of major events in patients treated for acute ST-segment elevation myocardial infarction (STEMI) in our clinic.Methods:Angiography records, demographic characteristics, and laboratory parameters of the patients who were diagnosed with acute STEMI in our clinic between February 2020 and December 2021 were examined. Patients were classified as being in Group 1 (discharge within 48 h) or Group 2 (discharge after 48 h), and rates of recurrent hospitalization, heart failure attacks, cardiovascular events, and death were compared between the two groups.Results:A total of 321 patients were included in our study. There were 129 patients in Group 1 and 192 patients in Group 2. There was no difference between the two Groups in terms of gender, age, or affected coronary vessels. The ejection fraction was lower in the late discharge group (p=0.004). The postoperative ventricular arrhythmia rate was found to be statistically significantly higher in the late discharge group (p=0.046). There was no difference in cardiovascular events between the first and sixth months in either group (p-values of 0.096 and 0.649, respectively).Conclusion:Considering the positive economic and psychosocial effects of early discharge for the patient and physician, when planning the discharge of patients with STEMI, patients with low comorbidity, unaffected ejection fractions, no malignant arrhythmia in their follow-up, and appropriate laboratory parameters can be evaluated for early discharge.
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Şahin et al. (2023) studied this question.
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