Same-day discharge after percutaneous coronary procedures-Structured review and comprehensive meta-analysis.

Abstract

Percutaneous coronary intervention is awell-established revascularization strategy for patients with coronary artery disease. The safety and feasibility of performing these procedures on asame-day discharge basis for selected patients has been studied in alarge number of mostly nonrandomized trials. An up to date literature review should focus on trials with radial access, representing the current standard for coronary procedures in Austria and other European countries. The aim of this consensus statement is to review the most recent evidence for the safety and feasibility of performing same-day discharge procedures in selected patients. Astructured literature search was performed using prespecified search criteria, focusing on trials with radial access procedures. Atotal of 44clinical trials and 4large meta-analyses were retrieved, spanning 21years of clinical evidence from 2001 to 2022. The outcome data from awide range of clinical settings were unanimous in showing no negative effect on early (24 h) or late (30day) major adverse events after same-day discharge coronary procedures. Based on nine prospective trials acomprehensive meta-analysis was compiled. Using 1‑month major adverse events data the pooled odds ratio of same-day discharge versus overnight stay procedures was 0.66 (95% confidence interval, CI 0.35-01.24; p = 0.19; I2 0%), indicating a noninferiority in carefully selected patients. Outcome data from same-day discharge coronary intervention trials with radial access confirm the robust safety profile showing no increase in the risk of major adverse events compared to overnight stay.