Discharge after primary percutaneous coronary intervention: the earlier the better?

Length of hospital stay after acute myocardial infarction (MI) has fallen from 6 weeks or more in the 1950s to just a few days in contemporary practice.1 Stepwise reductions in hospital stay were heralded by earlier mobilization, better risk stratification through echocardiography and exercise electrocardiogram testing, and lower complication rates after thrombolytic therapy. The implementation of primary percutaneous coronary intervention (PCI) as routine reperfusion therapy for ST elevation MI (STEMI) not only improved clinical outcomes, but also led to further reductions in length of stay.2 Nevertheless, the financial burden of providing acute MI care remains substantial and much of the direct cost arises from the period of hospitalization.3,4 Early discharge promotes more efficient care, it facilitates service delivery, it reduces the risk of hospital-acquired infections, and it is welcomed by patients. Whether or not hospital stay can be shortened safely still further is, therefore, an...