Abstract

BackgroundThe rational length of stay following non-complicated percutaneous coronary intervention (PCI) for Non-ST elevation myocardial infarction (NSTEMI) patients remains controversial. Few studies have examined the impact of early discharge on short-term outcomes in NSTEMI patients, but short-time discharge is not uncommon in real world practice. This study examined the impact of short time discharge following non-complicated PCI on 30-day net adverse clinical events in NSTEMI patients.MethodsThis retrospective study enrolled 1424 consecutive patients with NSTEMI diagnoses who underwent non-complicated PCI. Of these patients, 432 were discharged early (< 24 h), whereas the remaining 992 NSTEMI patients underwent routine discharge. The primary end points of the study were the net adverse clinical events including major adverse cardiac or cerebral events or access site vascular/bleeding complications within 30 days. The differences between the two groups were analyzed after propensity score matching to reduce selection bias.ResultsThe incidence of crude 30-day net adverse events was numerically higher in the long-time discharge group at 11.6% (115/992) compared with 8.6% (37/432) in the short-time discharge group, although this difference was not significant (P = 0.09). This difference was mainly due to lesser radial access selected in the long-time discharge group (827/932, 83.4% vs. 387/432, 89.5%, P < 0.0005). After PS matching to balance the access difference, there was no significant difference in the incidence of the events mentioned above between two groups.ConclusionsIf an NSTEMI patient undergoes PCI without any procedural or hospital complications, short-time discharge after successful PCI would be feasible and safe in selected NSTEMI patients.

Highlights

  • The rational length of stay following non-complicated percutaneous coronary intervention (PCI) for Non-ST elevation myocardial infarction (NSTEMI) patients remains controversial

  • We examined the impact of a short time frame of observation (< 24 h) following non-complicated PCI on 30-day major adverse cardiac or cerebral events and net adverse clinical events in these NSTEMI patients

  • B-type natriuretic peptide (BNP) and Troponin I (TnI) levels were greater in the short-time discharge group compared with the long-time discharge group (232 ± 24 pg/mL vs. 268 ± 33 pg/mL, P < 0.0005 and 16.45 ± 1.52 vs. 15.58 ± 1.46, P < 0.0005, respectively)

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Summary

Introduction

The rational length of stay following non-complicated percutaneous coronary intervention (PCI) for Non-ST elevation myocardial infarction (NSTEMI) patients remains controversial. Previous studies have demonstrated the safety and outcomes of short-term observation after elective percutaneous coronary intervention (PCI) with cautious patient selection [1,2,3,4,5], and the American College of Cardiology together with the Society for Cardiovascular Angiography and Interventions (ACC/SCAI) published a consensus document defining the length of stay following PCI [6]. These guidelines were only for cautiously selected patients, which restricted application of this consensus in real world practice. We examined the impact of a short time frame of observation (< 24 h) following non-complicated PCI on 30-day major adverse cardiac or cerebral events and net adverse clinical events in these NSTEMI patients

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