Conflict of interest: All authors involved in this study have no conflict of interest disclosures.
Coronary Artery Disease
Assessment of clinical outcomes related to early discharge after elective percutaneous coronary intervention†
Version of Record online: 20 SEP 2012
Copyright © 2012 Wiley Periodicals, Inc.
Catheterization and Cardiovascular Interventions
Volume 81, Issue 1, pages 6–13, 1 January 2013
How to Cite
Muthusamy, P., Busman, D. K., Davis, A. T. and Wohns, D. H. (2013), Assessment of clinical outcomes related to early discharge after elective percutaneous coronary intervention. Cathet. Cardiovasc. Intervent., 81: 6–13. doi: 10.1002/ccd.24537
- Issue online: 21 DEC 2012
- Version of Record online: 20 SEP 2012
- Accepted manuscript online: 28 JUN 2012 07:08AM EST
- Manuscript Accepted: 24 JUN 2012
- Manuscript Received: 29 APR 2012
Vol. 81, Issue 5, 908, Version of Record online: 21 MAR 2013
- patient discharge;
- practice guidelines;
- vascular complications;
- outcomes assessment;
- patient safety
To assess clinical outcomes of same-day discharge (SDD) patients after elective percutaneous coronary intervention (PCI).
An overnight stay after PCI has been the standard approach in the majority of institutions. Data supporting SDD while maintaining patient safety, based on contemporary United States practice, have not been well established.
Using institutional pre-, peri-, and post-procedural guidelines, short-term clinical outcomes of 200 consecutive patients discharged on the same day after elective PCI were prospectively studied. Major adverse cardiac events (MACE), access site and vascular complications, readmissions, and emergency room (ER) visits were assessed within 24 hrs and at 7-day post-SDD. MACE included cerebral vascular accidents, death, myocardial infarction, target vessel revascularization, pulmonary embolism, and emergent coronary artery bypass grafting.
The mean age of the population was 63.2 years; 75% were males. Of 200 patients, 75.5% were accessed femorally and 24.5% had radial access. Intra-procedural anticoagulation included bivalirudin alone (47%), bivalirudin with glycoprotein (GP) IIb/IIIa inhibitors (3.5%), heparin alone (37%), and heparin with GP IIb/IIIa inhibitors (12.5%). No major bleeding or MACE was reported within 24 hrs or at 7 days. Within 7 days, 8 (4%) patients experienced minor bleeding, 4 (2%) were readmitted, and 3 (1.5%) had ER visits only. Pseudoaneurysm occurred in 1 (0.5%) patient.
Our institution-specific guidelines identify low-risk PCI patients who can be safely considered candidates for SDD with virtually no short-term adverse consequences. © 2012 Wiley Periodicals, Inc.