Early Hospital Discharge (Within Six Hours) for Patients Undergoing Coronary Angioplasty

Abstract

Background: 24-hour hospitalization is common practice in patients (P) who underwent scheduled coronary angioplasty (PCI). Previous experiences propose same-day discharge in selected P. Methods: Prospective, comparative, randomized, single-blind study. P aged 18 to 75 years were included as candidates for a scheduled radial-access PCI with the possibility of accessing the emergency system in less than 40 minutes. P with left ventricular ejection fraction < 30%, creatinine > 1.5 mg/dL, heart failure, chronic obstructive pulmonary disease, decompensated diabetes or very complex coronary anatomy were excluded. The population was divided in two groups (G). G 1: same-day discharge in 6 hours. G2: discharge the next day. Primary endpoint: death or need for rehospitalization within 24 hours of the procedure. Follow-up was carried out by phone the night of the procedure and the next morning, in person at 48 hours, and by telephone after a month, six months and a year. Continuous variables were expressed as median and their respective interquartile range, and qualitative variables as percentages. Results: 80 P were randomized. Six P (7.5%) presented exclusion criteria during the procedure. There were no deaths or major cardiovascular events in either groups. At one year of follow-up, 3.75% of in-stent restenosis was detected. Troponin elevation was detected in 20 P (25%); 4 were P excluded due to complications during PCI, in the remaining 16 it had no clinical repercussion. Conclusion: In a population of patients between 55 and 75 years old, mostly male, with a high prevalence of previous myocardial in-farction, and ventricular function depression, a scheduled radial-access PCI could be performed with same day discharge in 6 hours, with an adequate safety margin.