Early Hospital Discharge Following PCI for Patients With STEMI

Regional heart attack services have improved clinical outcomes following ST-segment elevation myocardial infarction (STEMI) by facilitating early reperfusion by primary percutaneous coronary intervention (PCI). Early discharge after primary PCI is welcomed by patients and increases efficiency of hea...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2021-12, Vol.78 (25), p.2550-2560
Main Authors: Rathod, Krishnaraj S, Comer, Katrina, Casey-Gillman, Oliver, Moore, Lizzie, Mills, Gordon, Ferguson, Gordon, Antoniou, Sotiris, Patel, Riyaz, Fhadil, Sadeer, Damani, Tasleem, Wright, Paul, Ozkor, Mick, Das, Debashish, Guttmann, Oliver P, Baumbach, Andreas, Archbold, R Andrew, Wragg, Andrew, Jain, Ajay K, Choudry, Fizzah A, Mathur, Anthony, Jones, Daniel A
Format: Article
Language:English
Subjects:
Aged
COVID-19 - prevention & control
Critical Pathways
Female
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Patient Discharge
Percutaneous Coronary Intervention - statistics & numerical data
Prospective Studies
ST Elevation Myocardial Infarction - surgery
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Summary:Regional heart attack services have improved clinical outcomes following ST-segment elevation myocardial infarction (STEMI) by facilitating early reperfusion by primary percutaneous coronary intervention (PCI). Early discharge after primary PCI is welcomed by patients and increases efficiency of health care. This study aimed to assess the safety and feasibility of a novel early hospital discharge pathway for low-risk STEMI patients. Between March 2020 and June 2021, 600 patients who were deemed at low risk for early major adverse cardiovascular events (MACE) were selected for inclusion in the pathway and were successfully discharged in 30 days after discharge), with 0% cardiovascular mortality and MACE rates of 1.2%. This finding compared favorably with a historical group of 700 patients meeting pathway criteria who remained in the hospital for >48 hours (>48-hour control group) (mortality, 0.7%; MACE, 1.9%) both in unadjusted and propensity-matched analyses. Selected low-risk patients can be discharged safely following successful primary PCI by using a pathway that is supported by a structured, multidisciplinary virtual follow-up schedule.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2021.09.1379