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April 10, 2007Circulation

Same-day discharge after elective PCI was noninferior to overnight stay for the composite of death, MI, CABG, repeat PCI, or puncture complications at 24 hours (P<0.0001 for noninferiority).

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Why the study?

Does same-day discharge after elective PCI by femoral approach prevent complications compared to overnight hospital stay?

Population

800 consecutive patients scheduled for elective percutaneous coronary intervention (PCI) by femoral approach

Comparison

Same-day discharge vs Overnight hospital stay after PCI

Design

RCT, Randomized to same-day discharge or overnight hospital stay

Follow-up

24 hours

Key result

Same-day discharge after elective PCI was noninferior to overnight stay for the composite of death, MI, CABG, repeat PCI, or puncture complications at 24 hours (P<0.0001 for noninferiority).

Authors

GHG. HeydeKKKarel T. KochRWRobbert J. de Winter

Discussion

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Overview

Supports same-day discharge after elective femoral PCI; extends randomized evidence for this strategy.

Study Design

Type

RCT (n=800)

Randomization

randomized

Structured PICO

Does same-day discharge after elective PCI by femoral approach prevent complications compared to overnight hospital stay?

P
Population
800 consecutive patients scheduled for elective PCI by femoral approach, followed for 24 hours after PCI.
I
Intervention
Same-day discharge (discharged immediately if triaged as suitable 4 hours after PCI)
C
Comparator
Overnight hospital stay after PCI
O
Outcome
Composite of death, myocardial infarction, coronary artery bypass graft surgery, repeat PCI, or puncture-related complications occurring within 24 hours after PCIcomposite

Main Result

Effect estimate: risk difference -0.020 (95% CI -0.045 to -0.004)

Absolute Event Rate: 2.2% vs 4.2%

p-value: p=<0.0001 for noninferiority

Same-day discharge after elective PCI via femoral approach is feasible and non-inferior to overnight stay for 24-hour safety outcomes.

Cite This Study

Heyde et al. (2007) conducted an RCT in elective PCI by femoral approach (n=800). Same-day discharge vs. Overnight hospital stay was evaluated on death, myocardial infarction, coronary artery bypass graft surgery, repeat PCI, or puncture-related complications occurring within 24 hours after PCI (risk difference -0.020, 95% CI -0.045 to -0.004, p=<0.0001 for noninferiority). Same-day discharge after elective PCI was noninferior to overnight stay for the composite of death, MI, CABG, repeat PCI, or puncture complications at 24 hours (P<0.0001 for noninferiority).

synapsesocial.com/papers/6a84659bf6d812dcfa83dfbehttps://doi.org/10.1161/circulationaha.105.591495
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Same Day Discharge versus Overnight Stay in the Hospital following Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials2017 · 54 citations
  2. 2Prevalence and Outcomes of Same-Day Discharge After Elective Percutaneous Coronary Intervention Among Older Patients2011 · 127 citations
  3. 3Clinical outcomes of patients undergoing elective percutaneous coronary intervention with same-day discharge. Ten-year follow-up2021 · 1 citations
  4. 4Assessing Patient-Reported Outcomes and Preferences for Same-Day Discharge After Percutaneous Coronary Intervention2013 · 69 citations
  5. 5Safety, Feasibility and Economic Analysis of Same Day Discharge Following Elective Percutaneous Coronary Intervention2022 · 7 citations