Safety of same-day discharge after complex percutaneous coronary intervention

Abstract

Introduction

Since 1977 and first coronary angioplasty, developments in this field have been exponential. Outpatient coronary angioplasty is developing rapidly, driven by current economic needs, patients’ preference to be discharged the same day, and the aim of reducing nosocomial risks associated with hospitalisation, while maintaining sufficient safety for the patient.

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

Objective

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

Method

All patients over 18 years of age admitted to the outpatient cardiology unit at the Timone University Hospital (Marseille, France) for coronary angiography between 1 January 2023 and 31 December 2023 were included in the study if they received complex coronary angioplasty during the procedure.

Results

185 patients were included. The number of major events (MACE: cardiovascular mortality, myocardial infarction, stroke) at 3 months concerned 4 of the 172 patients, giving a MACE rate of 2.3% [95% CI 0.64% to 5.85%] (Table 1). These were 2 early events (2 stent thromboses) and 2 late events: 2 myocardial infarctions (NSTEMI). As regards secondary events, there were 6 hospitalisations following the procedure, i.e. 3.5% of patients, and 13 re-hospitalisations within 3 months of angioplasty for unscheduled cardiovascular reasons (7.6% of patients). The rate of major bleeding was 1.7% (3 patients).

Conclusion

Performing complex percutaneous coronary intervention in an outpatient unit appears feasible in terms of clinical safety. Patient selection is a key factor in the feasibility of outpatient management. Further randomised studies are needed to compare these patients with those admitted to hospital and confirm the trend observed.