Early Hospital Discharge Following PCI for Patients With STEMI

Area of Science:

• Cardiology
• Health Services Research

Background:

• Regional heart attack services improve outcomes for ST-elevation myocardial infarction (STEMI) through early reperfusion via primary percutaneous coronary intervention (PCI).
• Early hospital discharge after primary PCI offers patient benefits and enhances healthcare efficiency.

Purpose of the Study:

• To evaluate the safety and feasibility of a new early hospital discharge pathway for low-risk STEMI patients.
• To assess the clinical outcomes associated with this accelerated discharge protocol.

Main Methods:

• A pathway was implemented for 600 low-risk STEMI patients discharged in <48 hours between March 2020 and June 2021.
• Patients received structured telephone and virtual follow-ups at regular intervals up to 3 months post-discharge.

Main Results:

• The median hospital stay was significantly reduced to 24.6 hours compared to a pre-pathway median of 65.9 hours.
• During a median follow-up of 271 days, cardiovascular mortality was 0%, with a 1.2% rate of major adverse cardiovascular events (MACE).
• Outcomes compared favorably to a historical control group (0.7% mortality, 1.9% MACE).

Conclusions:

• A structured, multidisciplinary virtual follow-up supports the safe early discharge of selected low-risk STEMI patients after primary PCI.
• This pathway demonstrates a viable strategy for improving healthcare efficiency without compromising patient safety or clinical outcomes.