Same-Day Discharge After Outpatient PCI in a VA Hospital: Shared Decision Making and the VA MISSION Act

Gokhale, Sanket; Desai, Binnie; Twing, Aamir; Dickens, Helena; Shroff, Adhir

doi:10.1016/j.carrev.2020.04.033

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Ghanbari et al., 2020 [ 67 ] Observational, retrospective, single center Total: 876 SDD: 29% NSTE-ACS, lesion type A, B1, B2, C Denmark ND None MACE: death, stroke, MI, revascularization, vascular complications, CABG, rehospitalization, bleeding 30-day MACE: SDD 1.5% vs. OS 1.4% SDD: 190 OS: 21% OS: 91% of early adverse events within 9 h postprocedure OS: 686 13. Gokhale et al., 2020 [ 68 ] Retrospective, single center Total: 496 SDD: 100% Elective PCI, single vessel, bifurcation, RA USA ND None Primary: MACE (death, MI, stroke), TVR at 30 days 30-day MACE: SDD 0% vs. OS 1.3% ( p = 0.5) SDD: 76 OS: 100% Secondary: unscheduled medical contact OS: 138 14. Liew et al., 2020 [ 20 ] Observational, prospective, multicenter SDD: 586 SDD: 67.1% Elective PCI, complex (47.6%), MV (5.6%), LM (0.5%) Australia ND ND 30-day MACCE (death, MI, TLR, major bleeding), average costs 30-day MACCE: 0.7% SDD vs. 1.7% OS ( p = 0.253), 30-day rehospitalization: 0.7% SDD vs. 1.8% OS ( p = 0.159) OS: 17,515 OS: 45.5% Favorable patient perception 15.…”

Section: Methodsmentioning

confidence: 99%

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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