Key result
Same-day discharge after elective PCI was safe with 0% MACE at 12 months; successful discharge was predicted by radial access (OR 5.92; 95% CI 1.73-20.21) and less complex lesions.
Why the study?
Is same-day discharge safe and what are its predictors in patients undergoing elective percutaneous coronary intervention?
Observational (n=161)
No
Is same-day discharge safe and what are its predictors in patients undergoing elective percutaneous coronary intervention?
Absolute Event Rate: 0% vs 6.38%
Same-day discharge after elective PCI is safe and feasible, with success strongly predicted by radial access, less complex coronary lesions, and lower contrast volume.
May support selective same-day discharge after elective PCI; leaves open confirmation by randomized trials before practice change.
Background Although same-day discharge (SDD) after elective uncomplicated percutaneous coronary intervention (PCI) be adopted worldwide, it remains poorly studied in our country. We aim to evaluate our initial experience with SDD after elective PCI, regarding its safety and predictors of success. Methods A hundred and sixty-one single-center consecutive patients, selected in a specialized outpatient clinic, were included for SDD. To identify the factors associated with SDD, single and multiple logistic regression models were adjusted. Results SDD was successfully performed in 114 patients (70.8%) and the remaining 47 patients remained hospitalized (45 with discharge in the following morning and 2 patients after 2 days). No patient with SDD presented major adverse cardiac events or major vascular complications at 30 days or at a median follow-up of 12 months. In the inpatient group, there was only one case of acute myocardial infarction due to a lateral branch occlusion and two patients with > 5 cm hematoma related to the access site. The SDD predictors were radial access route (OR = 5.92; 95%CI 1.73-20.21; p = 0.005), presence of type A/B1 lesions (OR = 14.09; 95%CI 1.70-116.49%; p = 0.01) and contrast volume (OR = 0.76; 95%CI 0.65-0.88; p < 0.001). Conclusions SDD was safe and could be successfully performed in most patients selected for elective PCI, and its predictors were the radial access, less complex coronary lesions and a and lower contrast volume.
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Conejo et al. (2015) conducted an observational in Elective percutaneous coronary intervention (n=161). Same-day discharge vs. Hospitalization was evaluated on Major adverse cardiac events or major vascular complications. Same-day discharge after elective PCI was safe with 0% MACE at 12 months; successful discharge was predicted by radial access (OR 5.92; 95% CI 1.73-20.21) and less complex lesions.
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