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Very Early Discharge After Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction:

Bilal Bawamia1, Andrew Brown1, Ioakim Spyridopoulos2

  • 1Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, UK.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|September 4, 2022
PubMed

Insights

Early discharge after 24 hours for ST-segment elevation myocardial infarction (STEMI) patients undergoing uncomplicated primary percutaneous coronary intervention (PPCI) is safe. This strategy shows similar mortality rates to standard 48-72 hour stays.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Outcomes Research

Background:

  • Current guidelines permit early discharge (48-72h) for low-risk ST-segment elevation myocardial infarction (STEMI) patients post-uncomplicated primary percutaneous coronary intervention (PPCI).
  • This study investigates the safety and outcomes of an even earlier discharge strategy (24h) in this patient cohort.

Purpose of the Study:

  • To evaluate the safety and efficacy of a 24-hour in-hospital stay for STEMI patients following uncomplicated PPCI.
  • To compare 1- and 6-month mortality rates between early (24h) and standard (48-72h) discharge groups.

Main Methods:

  • Retrospective analysis of prospectively collected data from STEMI patients between January 2014 and December 2020.
  • Comparison of mortality rates between patients discharged after 24 hours (early discharge group) and those with a standard 2-day hospital stay (standard discharge group).

Main Results:

  • Of 4033 STEMI patients analyzed, 42% underwent early discharge.
  • No significant differences in 1-month (HR 0.54; P=0.23) or 6-month mortality (HR 0.73; P=0.35) were observed between early and standard discharge groups after adjustment.
  • Younger age, male sex, and lower peak troponin levels characterized the early discharge group.

Conclusions:

  • Next-day discharge is confirmed as a safe strategy for STEMI patients with a successful PPCI and uncomplicated post-procedural course.
  • Age, admission heart rate, and COPD are independent predictors of 6-month mortality in patients discharged early.
Abstract

Keywords:
Early dischargeMortalitySTEMI

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