Key result
Among 474 STEMI patients, early discharge (<48 hours) after primary angioplasty showed no differences in adverse events compared to delayed discharge, though overall event rates were low.
Why the study?
The safety of early discharge (less than 48 hours) in STEMI patients treated with primary angioplasty needed to be assessed.
Does early discharge (<48 hours) reduce all-cause mortality in STEMI patients treated with primary angioplasty?
Observational (n=474)
No
Does early discharge (<48 hours) reduce all-cause mortality in STEMI patients treated with primary angioplasty?
Early discharge (<48 hours) after primary angioplasty for STEMI appears safe with no difference in adverse events compared to delayed discharge, though limited by low overall event rates.
Should not yet change STEMI discharge practice; leaves open safety of early discharge pending randomized confirmation.
OBJECTIVE: To assess the safety of early discharge (less than 48 hours) in ST-segment elevation myocardial infarction (STEMI) patients treated with primary angioplasty (PA). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Armed Forces Institute of Cardiology & National Institute of Heart Diseases (AFIC-NIHD) From January 2017 to December 2017. METHODOLOGY: All STEMI patients, who underwent primary angioplasty in the above timeframe and then survived to be discharged to home, were included in the study. Patients were divided into two groups based on duration of hospital stay into early and delayed discharge groups (less or more than 48 hours, respectively). The primary outcome measure was all-cause mortality, on day-7, 30, 90, and 120-day post-discharge which was ascertained by personal or telephonic follow-up. RESULTS: During the 12-month study period, 495 patients were successfully discharged to home after PA. Of these, 21 were lost to follow-up. Only the 474 cases followed-up were included in the final analysis. There were 285 patients in early discharge group, and 189 in late discharge group. The mean duration of hospital stay was 64.2 hours. In a multiple logistic regression model, the time of discharge was not affected by age, gender, diabetes mellitus, hypertension, past history of cardiac, or cerebrovascular events, Killip class at presentation, infarct location, angiographic characteristics, procedural details and complications. CONCLUSION: There were no differences between the early (<48 h) and delayed (>48 h) discharge groups in terms of adverse events. However, this might be due to an overall low event rates in the study.
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Rehmat et al. (2020) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=474). Early discharge (<48 hours) vs. Delayed discharge (>48 hours) was evaluated on All-cause mortality on day-7, 30, 90, and 120-day post-discharge. Among 474 STEMI patients, early discharge (<48 hours) after primary angioplasty showed no differences in adverse events compared to delayed discharge, though overall event rates were low.
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