clinicaltrials.gov Identifier: NCT00091637.

Background: Same-day discharge following PCI reduces bed occupancy, is cost effective and popular with patients. Low-level elevations of troponin T (TnT) following PCI are common. Outcomes following same-day discharge of PCI patients with low-level TnT elevation are currently unknown.Methods: We prospectively studied a cohort of 885 patients undergoing elective PCI between May 2006 and December 2010 at our institution. All patients had TnT measured 6 h post procedure. Decisions regarding the suitability of same-day discharge were made 6 h post procedure. Patients with a suboptimal angiographic result, evidence of periprocedural ischaemia or infarction (prolonged chest pain, ECG changes or TnT > 0.15 g/mL), access site complications, requiring a glycoprotein IIb/IIIa infusion or inadequate social circumstances were admitted. Demographic, procedural and outcomes data at 24-h and 30 days were recorded.Results: Of 774 TnT negative patients, 698 (90.2%) were successfully discharged home on the same day (Group 1). Post-procedural TnT elevation (>0.03 g/mL) was observed in 101 patients, of whom 52 were discharged home same day (Group 2). The mean TnT level in this group was 0.07 g/mL. There was no MACE (death, MI, stent thrombosis or TVR) within 24 h of discharge in either group 1 or group 2. Readmission for any reason within 24 h was rare and did not differ between group 1 and group 2. Similarly, 30-day outcomes were comparable between groups. * All comparisons between groups at 24-h and 30 days non-significant. Conclusion:In the setting of an established day-case PCI program with clear clinical guidance for patient management, same-day discharge of patients with lowlevel TnT release is safe and not associated with adverse events.http://dx.

The process for development of these consensus Australasian antifungal guidelines for use in adult patients with haematological malignancy is described. New features included, how the guidelines should be applied, the risk assessment tool used and the grading system for evidence and strength of recommendation are discussed.

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