Background: Sleep deprivation is known to adversely affect physician performance. The aim of our study was to examine the potential hazard of percutaneous coronary intervention (PCI) performed by post-call interventional cardiologists. Methods: We compared major adverse clinical events (MACE: death, major bleeding, myocardial infarction, stroke, urgent target vessel revascularization) in 779 patients who underwent PCI by an interventionalist who performed unrelated emergency PCI between 6 pm and 7 am after the previous work day (Group 1, post-call PCI), to that observed in 14,919 control patients during the same study enrollment period (Group 2, control). Results: Using the previously validated Mayo Clinic PCI risk score, there was no difference between observed and expected rates of in-hospital major adverse clinical events for patients who had post-call PCI (OR=0.85, 95% CI=0.57-1.27, p=0.43). Comparing Group 1 and Group 2 patients, there was no difference in MACE rates for patients who had elective PCI (OR, 1.21; 95% CI = 0.91 to 1.60; p=0.20), or for those who had PCI for acute coronary syndromes (OR, 1.17; 95% CI=0.78 to 1.74;p=0.45). There also was no difference in MACE rates between the two groups when analyzed according to the timing of on call emergency PCI (6 pm to 11 pm, OR, 1.27; 95% CI=0.94 to 1.72; 11 pm to 4 am OR, 1.12; 95% CI=0.75 to 1.65; and 4 am to 8 am, OR, 0.94; 95% CI=0.65 to 1.38). Conclusions: In this single-institution registry study, PCI performed by an interventionalist on the day after performing on-call emergent PCI was not associated with increased rates of in-hospital major adverse clinical events.
P., S., A., V., R., L., C., R., D., H., & M., B. (2012). Sleep deprivation and the hazard of percutaneous coronary intervention. Journal of the American College of Cardiology, 59(13), E1834. Retrieved from http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L70715274