Abstract
Background Same-day discharge for percutaneous coronary interventions is an attractive and safe strategy. Observational and randomized data show equivalent results as compared to overnight observation. In addition, it ensues great savings for the healthcare system. Nevertheless, in Brazil, this approach is underused. The objective of this study was to describe the characteristics and outcomes of patients undergoing percutaneous coronary intervention with same-day discharge. Methods A single-center study with patients who underwent selected procedures, uneventful, discharged on the same day. Clinical and angiographic characteristics were described. Major cardiovascular events and complications were analyzed, reported, and compared to a historical cohort. Results A total of 413 patients were included, mean age of 64±10 years. After a 30-day follow-up, no major cardiovascular event was observed in selected patients submitted to the same-day discharge strategy. In addition, we found an increase in clinical and angiographic complexity as compared to the previous series, which did not translate to rise in adverse outcomes. Conclusion Uncomplicated percutaneous coronary interventions, with same-day discharge, are safe among appropriately selected patients, encouraging further adoption of this approach.
Highlights
Percutaneous coronary intervention (PCI) is currently one of the most frequent invasive cardiologic procedures conducted in the world
After a 30-day follow-up, no major cardiovascular event was observed in selected patients submitted to the sameday discharge strategy
The patients were evaluated by the interventional cardiologist, who used the following inclusion criteria: patients with stable angina, crescendo angina or asymptomatic, with a positive test for ischemia; absence of significant decompensated comorbidities; absence of periprocedural complications; absence of prolonged chest pain or post-PCI electrocardiographic alterations; absence of vascular complications; PCI conducted before the 13th hour of the day, and the patient living within 30 km away from the catheterization laboratory and having company overnight
Summary
Percutaneous coronary intervention (PCI) is currently one of the most frequent invasive cardiologic procedures conducted in the world. One-night hospital stay after PCI is the standard procedure to monitor post-procedural complications, such as major bleeding, complications at the entry site and ischemic coronary events.[2] Developments in interventional cardiology in recent years, especially with the optimal stent deployment, dual antiplatelet therapy, material with smaller profile, and the use of the radial access have led to consistent good results and reduction in these acute complications. According to the National Cardiovascular Data Registry (NCDR) CathPCI Registry, elective PCIs in patients with chronic coronary artery disease have a high success rate (99.2%) and low complication rate (0.17% need for emergency surgery and 0.65% in-hospital mortality).[2] When present, these complications appear within the first 6 hours or 24 to 48 hours after the procedure, it is possible to challenge the need for a routine overnight stay to monitor complications.[2,3]
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