Same-day discharge after percutaneous coronary procedures-Structured review and comprehensive meta-analysis
Mathias C Brandt1, Hannes Alber2, Rudolf Berger3
1Department of Internal Medicine II, Paracelsus Medical University, Salzburg, Austria.
Wiener Klinische Wochenschrift
|May 14, 2024
Summary
Same-day discharge after percutaneous coronary intervention (PCI) using radial access is safe and feasible for selected patients. This approach shows no increased risk of major adverse events compared to overnight stays, supporting its use in modern cardiology.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Percutaneous coronary intervention (PCI) is a standard treatment for coronary artery disease.
- Same-day discharge protocols for PCI have been evaluated in numerous trials, primarily nonrandomized.
- Radial access is the current standard for PCI in many European countries, including Austria.
Purpose of the Study:
- To review current evidence on the safety and feasibility of same-day discharge PCI.
- To focus on trials utilizing radial access, reflecting contemporary practice.
Main Methods:
- A structured literature search was conducted.
- The search focused on trials involving radial access PCI procedures.
- Data from clinical trials and meta-analyses were analyzed.
Main Results:
- 44 clinical trials and 4 meta-analyses (2001-2022) were reviewed.
- No negative impact on 24-hour or 30-day major adverse events was observed for same-day discharge PCI.
- A meta-analysis of 9 prospective trials indicated noninferiority for same-day discharge versus overnight stay (pooled OR 0.66, 95% CI 0.35-1.24, p=0.19).
Conclusions:
- Same-day discharge PCI with radial access demonstrates a robust safety profile.
- There is no increased risk of major adverse events compared to traditional overnight stays.
- This approach is safe for carefully selected patients undergoing coronary intervention.
Keywords:
Ambulatory coronary interventionInterventional cardiologyMeta-analysisOutpatient treatmentStructured reviewMore Related Videos
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