Safety of early discharge after primary angioplasty

Abstract

Objective: To assess the safety of early discharge (less than 48 hours) in ST-segment elevation myocardial infarction (STEMI) patients treated with primary angioplasty (PA). Study Design: Observational study. Place and Duration of Study: Armed Forces Institute of Cardiology & National Institute of Heart Diseases (AFIC-NIHD) From January 2017 to December 2017. Methodology: All STEMI patients, who underwent primary angioplasty in the above timeframe and then survived to be discharged to home, were included in the study. Patients were divided into two groups based on duration of hospital stay into early and delayed discharge groups (less or more than 48 hours, respectively). The primary outcome measure was all-cause mortality, on day-7, 30, 90, and 120-day post-discharge which was ascertained by personal or telephonic follow-up. Results: During the 12-month study period, 495 patients were successfully discharged to home after PA. Of these, 21 were lost to follow-up. Only the 474 cases followed-up were included in the final analysis. There were 285 patients in early discharge group, and 189 in late discharge group. The mean duration of hospital stay was 64.2 hours. In a multiple logistic regression model, the time of discharge was not affected by age, gender, diabetes mellitus, hypertension, past history of cardiac, or cerebrovascular events, Killip class at presentation, infarct location, angiographic characteristics, procedural details and complications. Conclusion: There were no differences between the early (<48 h) and delayed (>48 h) discharge groups in terms of adverse events. However, this might be due to an overall low event rates in the study.