January 9, 2017PLoS ONEOpen Access

Same day discharge following percutaneous coronary intervention did not significantly differ from overnight hospital stay in the incidence of major adverse cardiac events (OR 0.45, 95% CI 0.20-1.02; P=0.06) in patients with stable coronary artery disease.

Q: What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Stable coronary artery disease (n=3081). Intervention: Same day discharge following PCI vs. Overnight stay in the hospital following PCI. Primary outcome: Major adverse cardiac events (MACEs) (OR 0.45, 95% CI 0.20-1.02, p=0.06).

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Why the study?

Does same-day discharge reduce adverse cardiovascular outcomes compared to overnight stay in patients with stable CAD undergoing PCI?

Population

8 RCTs pooling 3081 patients with stable coronary artery disease undergoing percutaneous coronary intervention

Comparison

Same-day discharge following PCI vs Overnight stay in the hospital following PCI

Design

Meta-analysis

Follow-up

30 days

Key result

Same day discharge following percutaneous coronary intervention did not significantly differ from overnight hospital stay in the incidence of major adverse cardiac events (OR 0.45, 95% CI 0.20-1.02; P=0.06) in patients with stable coronary artery disease.

Authors

PBPravesh Kumar BundhunInterventional Cardiology MSMohammad Zafooruddin Sani SoogundGuangxi Medical University WHWeiqiang HuangBoston University

Discussion

Member takes

Overview

Supports same-day discharge after PCI in stable CAD as comparably safe; extends RCT meta-analysis evidence for outpatient feasibility without excess events.

Study Design

Type

Meta-Analysis (n=3,081)

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does same-day discharge reduce adverse cardiovascular outcomes compared to overnight stay in patients with stable CAD undergoing PCI?

Population

3,081 patients with stable coronary artery disease undergoing percutaneous coronary intervention, randomized to same-day discharge or overnight hospital stay, followed for up to 30 days.

Intervention

Same-day discharge following PCI

Comparator

Overnight stay in the hospital following PCI

Outcome

Adverse cardiovascular outcomes (mortality, myocardial infarction, and major adverse cardiac events) observed during a 30-day periodcomposite

Main Result

Odds Ratio: 0.45 (95% CI 0.2–1.02)

p-value: p=0.06

Same-day discharge following PCI in patients with stable CAD appears safe, with no significant increase in 30-day adverse cardiovascular outcomes compared to overnight hospital stay.

Limitations

A limited number of patients were analyzed, which might not provide robust results.
Moderate and high levels of heterogeneity were observed among several subgroups analyzing bleeding, any adverse event, and repeated revascularization.
Selection bias, publication bias, and language bias could have occurred because only English language publications were used.
Three of the trials included patients with low risk ACS, and one trial included patients with unstable angina, which might have contributed to heterogeneous results.
Similar study design was not reported in all of the eight trials, which might have contributed to the introduction of bias.
Lack of long-term follow-up data

Cite This Study

Bundhun et al. (2017) conducted a meta-analysis in Stable coronary artery disease (n=3,081). Same day discharge following PCI vs. Overnight stay in the hospital following PCI was evaluated on Major adverse cardiac events (MACEs) (OR 0.45, 95% CI 0.20-1.02, p=0.06). Same day discharge following percutaneous coronary intervention did not significantly differ from overnight hospital stay in the incidence of major adverse cardiac events (OR 0.45, 95% CI 0.20-1.02; P=0.06) in patients with stable coronary artery disease.

synapsesocial.com/papers/6a9cf8496a0b47dac776fbda https://doi.org/10.1371/journal.pone.0169807

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January 9, 2017PLoS ONEOpen Access

Same day discharge following percutaneous coronary intervention did not significantly differ from overnight hospital stay in the incidence of major adverse cardiac events (OR 0.45, 95% CI 0.20-1.02; P=0.06) in patients with stable coronary artery disease.

View Full Paper

Ask AI

Bookmark

Why the study?

Does same-day discharge reduce adverse cardiovascular outcomes compared to overnight stay in patients with stable CAD undergoing PCI?

Population

8 RCTs pooling 3081 patients with stable coronary artery disease undergoing percutaneous coronary intervention

Comparison

Same-day discharge following PCI vs Overnight stay in the hospital following PCI

Design

Meta-analysis

Follow-up

30 days

Key result

Authors

PBPravesh Kumar BundhunInterventional Cardiology MSMohammad Zafooruddin Sani SoogundGuangxi Medical University WHWeiqiang HuangBoston University

Discussion

Member takes

Overview

Supports same-day discharge after PCI in stable CAD as comparably safe; extends RCT meta-analysis evidence for outpatient feasibility without excess events.

Study Design

Type

Meta-Analysis (n=3,081)

Randomization

Randomized

Multicenter

Yes

Structured PICO

Does same-day discharge reduce adverse cardiovascular outcomes compared to overnight stay in patients with stable CAD undergoing PCI?

Population

3,081 patients with stable coronary artery disease undergoing percutaneous coronary intervention, randomized to same-day discharge or overnight hospital stay, followed for up to 30 days.

Intervention

Same-day discharge following PCI

Comparator

Overnight stay in the hospital following PCI

Outcome

Adverse cardiovascular outcomes (mortality, myocardial infarction, and major adverse cardiac events) observed during a 30-day periodcomposite

Main Result

Odds Ratio: 0.45 (95% CI 0.2–1.02)

p-value: p=0.06

Same-day discharge following PCI in patients with stable CAD appears safe, with no significant increase in 30-day adverse cardiovascular outcomes compared to overnight hospital stay.

Limitations

A limited number of patients were analyzed, which might not provide robust results.
Moderate and high levels of heterogeneity were observed among several subgroups analyzing bleeding, any adverse event, and repeated revascularization.
Selection bias, publication bias, and language bias could have occurred because only English language publications were used.
Three of the trials included patients with low risk ACS, and one trial included patients with unstable angina, which might have contributed to heterogeneous results.
Similar study design was not reported in all of the eight trials, which might have contributed to the introduction of bias.
Lack of long-term follow-up data

Cite This Study

synapsesocial.com/papers/6a9cf8496a0b47dac776fbda https://doi.org/10.1371/journal.pone.0169807

Also Consider

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

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