Key result
Very early discharge after primary PCI shows similar 3-month MACE rates compared to routine discharge.
Why the study?
Very early discharge after successful primary PCI is increasingly considered for carefully selected low-risk STEMI patients, but prospective data from resource-limited settings remain limited.
Does very early discharge (<=48 hours) safely prevent or avoid an increase in major adverse cardiovascular events at 3 months compared to routine discharge (>48 hours) in low-risk STEMI patients treated with primary PCI?
RCT (n=179)
Open-label
Randomized
No
Does very early discharge (<=48 hours) safely prevent or avoid an increase in major adverse cardiovascular events at 3 months compared to routine discharge (>48 hours) in low-risk STEMI patients treated with primary PCI?
Very early discharge within 48 hours after successful radial-access primary PCI is safe and feasible in carefully selected low-risk STEMI patients, with no increase in 3-month major adverse cardiovascular events compared to routine discharge.
Supports very early discharge in selected low-risk STEMI after successful PCI; confirms similar 3-month MACE rates versus routine discharge.
Background Very early discharge after successful primary percutaneous coronary intervention (PCI) has been increasingly considered for carefully selected low-risk patients with ST-segment elevation myocardial infarction (STEMI). However, prospective data from resource-limited settings remain limited. Objective To evaluate the safety and feasibility of very early discharge (≤48 hours) in low-risk STEMI patients treated with primary PCI. Methods We conducted a prospective, randomized, open-label, single-center study between June 2024 and June 2025. During this period, 544 consecutive patients were admitted with STEMI. Among them, 179 met predefined low-risk criteria based on preserved left ventricular ejection fraction, limited coronary artery disease burden, and successful radial-access PCI. These patients were randomly assigned to either very early discharge (≤48 hours) or routine discharge (>48 hours). The primary endpoint was the occurrence of major adverse cardiovascular events (MACE) at 3 months, defined as all-cause mortality, recurrent myocardial infarction, hospitalization for heart failure, or stent thrombosis. Results A total of 82 patients were allocated to the very early discharge group, with a median hospital stay of 25.8 hours, and 97 patients to the routine discharge group. At 3-month follow-up, the incidence of MACE was similar between the two groups, with with no statistically significant difference in MACE (2.4% vs 2.1%; p = 1.00). Conclusion In this prospective randomized study of carefully selected low-risk STEMI patients, very early discharge within 48 hours after primary PCI was not associated with an increased risk of adverse cardiovascular events at 3 months. These findings suggest that an individualized early discharge strategy may be safely implemented in selected patients.
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Yahya et al. (2026) conducted an RCT in Low-risk ST-segment elevation myocardial infarction (STEMI) (n=179). Very early discharge (≤48 hours) vs. Routine discharge (>48 hours) was evaluated on Major adverse cardiovascular events (MACE) at 3 months (composite of all-cause mortality, recurrent myocardial infarction, hospitalization for heart failure, or stent thrombosis) (p=1.00). Very early discharge (≤48 hours) after primary PCI in low-risk STEMI patients showed similar 3-month MACE rates compared to routine discharge (2.4% vs 2.1%; P=1.00).
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