Key result
Outpatient diagnostic coronary angiography was safe and effective, with major cardiovascular complications occurring in only 0.15% of patients discharged home and 0.47% of patients transferred back to referring hospitals.
Why the study?
To evaluate the safety and clinical efficacy of outpatient coronary angiography across different patient groups based on a 6-year single-center experience.
Observational (n=2,166)
No
Absolute Event Rate: 0.15% vs 0.47%
p-value: p=0.33
Outpatient coronary angiography is safe and clinically effective, with an extremely low incidence of complications, allowing for optimized invasive diagnostics and reduced hospitalization costs.
Supports outpatient diagnostic coronary angiography feasibility; observational data leave open need for randomized confirmation before practice change.
AIM: To study the safety and clinical efficacy of an outpatient coronary angiography in various groups of patients according to a 6-year experience of the laboratory of endovascular diagnostic and treatment methods in the outpatient setting of the NMRC of Cardiology. MATERIALS AND METHODS: 2166 patients which underwent an outpatient coronary agiography from March 2009 to December 2014 were included. The success criteria was the successful completion of the procedure without the occurrence of major cardiovascular complications (death, transmural myocardial infarction; acute cerebrovascular accident, emergency cardiac surgery). RESULTS: All 2166 patients included in the study were divided into 2 groups: Group 1 - 1316 patients who were discharged home several hours after the study; Group 2 - 850 patients directed from hospitals without catheterization laboratories with the same-day discharge back to the referring hospital. From a clinical point of view, in the second group there were more severe patients. However, the study was successfully completed in all patients in both groups. There were no major adverse cardiovascular complications during the procedure and within 24 hours. In the 1st group, unplanned hospitalization occurred in 2.1% of cases, the cause of which in 93% of cases was the detection during angiography of a critical lesion ≥70% of the left main coronary artery. CONCLUSION: In our work, the incidence of complications was extremely low and not significantly different in both groups of patients. This is due to the fact that in patients with a more severe symptoms underwent a preliminary stabilization of their clinical condition. The introduction of outpatient technologies will optimize the invasive diagnostics and reduce the costs associated with hospitalization.
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Danilushkin et al. (2019) conducted an observational in Ischemic heart disease (n=2,166). Outpatient diagnostic coronary angiography with discharge home vs. Outpatient diagnostic coronary angiography with same-day transfer to referring hospital was evaluated on Major cardiovascular complications (death, Q-wave MI, stroke, emergency cardiac surgery) during the procedure and within 24 hours (p=0.33). Outpatient diagnostic coronary angiography was safe and effective, with major cardiovascular complications occurring in only 0.15% of patients discharged home and 0.47% of patients transferred back to referring hospitals.
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