[Safety of same-day-discharge strategy in complex percutaneous coronary intervention: Insights from a monocentric...

Since 1977 and the first coronary angioplasty, developments in this field have been exponential. Same day discharge after percutaneous coronary intervention is developing rapidly, driven by simplification of the procedure, current economic needs and patients' preference to be discharged the same day, while maintaining sufficient safety.

The aim of the study was to investigate the safety of same day discharge after complex percutaneous coronary intervention.

All patients over 18 years old admitted to the outpatient cardiology unit at the Timone University Hospital (Marseille, France) for coronary angiography between 1st January 2023 and 31 December 2023 were included in the study if a complex percutaneous coronary intervention was achieved during the procedure.

In total, 177 patients were included. Four patients experienced a major adverse cardiovascular event at 3months defined as composite of cardiovascular mortality, myocardial infarction and stroke, giving a major adverse cardiovascular event rate of 2.3% [95% CI: 0.64% to 5.85%]. These were 2 early events (2 stent thromboses) and 2 late events (2 myocardial infarctions). As regards secondary events, there were 6 hospitalizations following the procedure (3.4% of patients), and 13 re-hospitalizations within 3months of angioplasty for unscheduled cardiovascular reasons (7.3% of patients). The rate of major bleeding was 1.7% (3 patients).

Same day discharge after complex percutaneous coronary intervention appears feasible in terms of clinical safety. Patient selection is a key factor in the feasibility of outpatient management. Further randomized studies are needed to compare these patients with those staying longer in hospital and confirm the trend observed.