Safety of same-day discharge in patients with left main percutaneous intervention

Abdel‐Razek, Omar; Jung, Young; Jung, Richard G.; Skanes, Stephanie; Dhaliwal, Shan; Stotts, Cameron; Santo, Pietro Di; Goh, Cheng Yee; Verreault-Julien, Louis; Visintini, Sarah; Bradley, Jennifer; Simard, Trevor; Ramirez, F. Daniel; Russo, Juan; Froeschl, Michael; Labinaz, Marino; Hibbert, Benjamin

doi:10.1097/mca.0000000000001121

Cited by 3 publications

(8 citation statements)

References 7 publications

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“…Taxiarchi et al., 2021 [ 38 ] Retrospective, multicenter, longitudinal SDD: 1201 SD: 48% Elective RA PCI, MV (14%), CTO (10%), LM (8.0%) UK 6% ND 30-day MACE 30-day MACE: SDD 0.5% vs. OS 0.35% ( p = 0.409) OS: 3390 OS: 30% 20. Abdel-Razek et al., 2022 [ 42 ] Observational, retrospective SDD: 267 SDD: 46.8% Elective LM PCI Canada ND None (3.4% > 48h) Death, MI, rehospitalization at 30 days Prim. composite EP significantly lower in SDD (OR 4.3; 95% CI 1.1–6.0) OS: 194 OS: 34.5% No adverse events < 48h 21.…”

Section: Methodsmentioning

confidence: 99%

“…Currently in Austria LM PCI is not routinely performed with SDD patient management; however, substantial experience does exist with SDD even in this high-risk setting. Out of 44 trials listed in Tables 1 and 2 14 included LM PCI procedures, 3 trials [ 21 , 24 , 42 ] specifically targeted LM PCIs in a SDD setting. A Canadian study compared the outcome of elective LM PCI in 267 patients treated as SDD to 194 patients with OS [ 42 ].…”

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

“…Out of 44 trials listed in Tables 1 and 2 14 included LM PCI procedures, 3 trials [ 21 , 24 , 42 ] specifically targeted LM PCIs in a SDD setting. A Canadian study compared the outcome of elective LM PCI in 267 patients treated as SDD to 194 patients with OS [ 42 ]. Patients in the SDD group were younger (70.9 ± 10.1 years versus 73.4 ± 10.8 years), more frequently had prior cardiac catheterization and showed a larger percentage of protected LM stenoses (51.7% versus 35.1%).…”

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

“…Patients in the SDD group were younger (70.9 ± 10.1 years versus 73.4 ± 10.8 years), more frequently had prior cardiac catheterization and showed a larger percentage of protected LM stenoses (51.7% versus 35.1%). The composite primary endpoint of 30-day mortality, myocardial infarction and rehospitalization was significantly lower in the SDD group (OR 4.3; 95% CI 1.1–6.0, p = 0.002) [ 42 ]. This remarkable outcome depends, at least in part, on the inherent selection bias of SDD suitable patients following current recommendations.…”

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

“…Conversely, however, it does underline the robustness of the SDD concept with correct patient selection even in complex interventions. One of the most remarkable findings regarding the standard OS as a safety precaution was, once again, the timing of complications: All MACEs occurred beyond 48 h postprocedure, therefore OS would have provided no additional safety benefit [ 42 ].…”

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

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Same-day discharge after percutaneous coronary procedures—Structured review and comprehensive meta-analysis

Brandt,

Alber,

Berger

et al. 2024

Wien Klin Wochenschr

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Summary Introduction Percutaneous coronary intervention is a well-established revascularization strategy for patients with coronary artery disease. The safety and feasibility of performing these procedures on a same-day discharge basis for selected patients has been studied in a large number of mostly nonrandomized trials. An up to date literature review should focus on trials with radial access, representing the current standard for coronary procedures in Austria and other European countries. Methods The aim of this consensus statement is to review the most recent evidence for the safety and feasibility of performing same-day discharge procedures in selected patients. A structured literature search was performed using prespecified search criteria, focusing on trials with radial access procedures. Results A total of 44 clinical trials and 4 large meta-analyses were retrieved, spanning 21 years of clinical evidence from 2001 to 2022. The outcome data from a wide range of clinical settings were unanimous in showing no negative effect on early (24 h) or late (30 day) major adverse events after same-day discharge coronary procedures. Based on nine prospective trials a comprehensive meta-analysis was compiled. Using 1‑month major adverse events data the pooled odds ratio of same-day discharge versus overnight stay procedures was 0.66 (95% confidence interval, CI 0.35–01.24; p = 0.19; I2 0%), indicating a noninferiority in carefully selected patients. Conclusion Outcome data from same-day discharge coronary intervention trials with radial access confirm the robust safety profile showing no increase in the risk of major adverse events compared to overnight stay.

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Section: Methodsmentioning

confidence: 99%

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

Section: Data On Safety Of Sdd In Specific Patients/settingsmentioning

confidence: 99%

See 3 more Smart Citations

Same-day discharge after percutaneous coronary procedures—Structured review and comprehensive meta-analysis

Brandt,

Alber,

Berger

et al. 2024

Wien Klin Wochenschr

View full text Add to dashboard Cite

show abstract

Same-day discharge after percutaneous coronary procedures—Consensus statement of the working group of interventional cardiology (AGIK) of the Austrian Society of Cardiology

Brandt,

Alber,

Berger

et al. 2024

Wien Klin Wochenschr

View full text Add to dashboard Cite

Summary Introduction Percutaneous coronary intervention is a well-established revascularization strategy for patients with coronary artery disease. Recent technical advances such as radial access, third generation drug-eluting stents and highly effective antiplatelet therapy have substantially improved the safety profile of coronary procedures. Despite several practice guidelines and a clear patient preference of early hospital discharge, the percentage of coronary procedures performed in an outpatient setting in Austria remains low, mostly due to safety concerns. Methods The aim of this consensus statement is to provide a practical framework for the safe and effective implementation of coronary outpatient clinics in Austria. Based on a structured literature review and an in-depth analysis of available practice guidelines a consensus statement was developed and peer-reviewed within the working group of interventional cardiology (AGIK) of the Austrian Society of Cardiology. Results Based on the available literature same-day discharge coronary procedures show a favorable safety profile with no increase in the risk of major adverse events compared to an overnight stay. This document provides a detailed consensus in various clinical settings. The most important prerequisite for same-day discharge is, however, adequate selection of suitable patients and a structured peri-interventional and postinterventional management plan. Conclusion Based on the data analysis this consensus document provides detailed practice guidelines for the safe operation of daycare cathlab programs in Austria.

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The Impact of Age, Comorbidities, and Discharge Timing on Clinical Outcomes Following Elective Percutaneous Coronary Intervention

Khan,

Nawaz,

Amin

et al. 2024

Cureus

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Background The adoption of same-day discharge (SDD) in elective percutaneous coronary intervention (PCI) procedures offers potential benefits in terms of patient satisfaction and reduced healthcare costs. Despite these advantages, the safety and efficacy of SDD, especially among patients with diverse health profiles, are not fully understood. This study investigates the effects of patient-specific factors, including age, comorbidities, and discharge timing, on the clinical outcomes of elective PCI, focusing on the viability of SDD. Methods A prospective study was carried out at Lady Reading Hospital, Peshawar, Pakistan, involving 220 patients undergoing elective PCI from January to June 2023. This research compared the clinical outcomes of patients discharged on the same day with those who had extended hospital stays, examining the impact of age, comorbidities, and PCI success. Main outcome measures included post-procedure complications and hospital readmissions within 30 days. Results The study enrolled participants with an average age of 62 years, the majority (88%, n=194/220) of whom had comorbidities. Interestingly, 16% (n=35/220) of the participants were discharged on the same day, while the rest stayed longer in the hospital. Notably, those in the SDD group experienced significantly more complications and readmissions, with 95.14% (n=33/36) compared to only 16.22% (n=30/184) in their counterparts. Factors such as age, comorbidities, success of PCI, timing of discharge, and patient satisfaction emerged as significant predictors of the observed outcomes. Conclusion This study highlights the essential role of personalized care in discharge planning following elective PCI, advocating for a cautious approach towards SDD, especially for older patients and those with multiple health issues.

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Safety of same-day discharge in patients with left main percutaneous intervention

Cited by 3 publications

References 7 publications

Same-day discharge after percutaneous coronary procedures—Structured review and comprehensive meta-analysis

Same-day discharge after percutaneous coronary procedures—Structured review and comprehensive meta-analysis

Same-day discharge after percutaneous coronary procedures—Consensus statement of the working group of interventional cardiology (AGIK) of the Austrian Society of Cardiology

The Impact of Age, Comorbidities, and Discharge Timing on Clinical Outcomes Following Elective Percutaneous Coronary Intervention

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