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Same day discharge for percutaneous coronary intervention – A 4-year single-center experience
Session:
Sessão de Posters 29 - Intervenção coronária percutânea
Speaker:
Mónica Dias
Congress:
CPC 2024
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Cartazes
FP Number:
---
Authors:
Mónica Dias; Fernando Mané; Rodrigo Silva; Inês Conde; Sofia Fernandes; Carla Ferreira; Filipe Vilela; Catarina Quina; João Costa; Jorge Marques; Carlos Galvão Braga
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">INTRODUCTION: Percutaneous coronary intervention (PCI) is a broadly performed procedure worldwide. Radial access and technical advances have increased safety, maintaining a high degree of efficacy. Consequently, same-day discharge (SDD) can be considered for a significant number of patients who otherwise would have required overnight stay. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">AIM: To evaluate safety and feasibility of elective outpatient PCI in low-risk selected patients. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">METHODS: A retrospective single-centre observational study of patients with chronic coronary syndromes who underwent elective PCI from October 2019 to November 2023. Patents who qualified SDD were defined according to clinical, angiographic, and sociodemographic characteristics. Patient and procedure characteristics were collected from local databases and SDD-PCI adverse events (all-cause mortality, acute coronary syndrome (ACS), stent thrombosis, reintervention, major bleeding, stroke, contrast-induced renal failure, vascular access complications) at 30-days were analysed.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">RESULTS: The study included 560 patients, 78% males with a mean age of 66 ± 10 years, that underwent elective PCI. Most patients were discharged in the same day (n= 546, 84%). There were three adverse events (0.6%) during the 30-day follow-up period of the patients treated in ambulatory regimen. One ACS more than 72h after the discharge - given the presence of stage 5 chronic kidney disease and a previous complex PCI of RCA, with mild elevation of troponin I and no changes in echocardiogram, a new coronarography was not performed and therefore we do not know if the ACS was related to the targe lesion of PCI; two patients who present with major bleeding (both gastrointestinal) at 3 and 12 days after PCI.</span></span></p> <p style="margin-right:53px; text-align:justify"><span style="font-size:11pt"><span style="font-family:"Helvetica Neue",serif"><span style="color:black"><span style="font-family:"Calibri",sans-serif">CONCLUSIONS: The presented descriptive analysis endorses that SDD-PCI is a safe</span> <span style="font-family:"Calibri",sans-serif">procedure. Protocol implementation is key to guide interventional cardiologists in low</span> <span style="font-family:"Calibri",sans-serif">risk patient selection. The potential role in decreasing bed-shortage, hospital</span> <span style="font-family:"Calibri",sans-serif">overcrowding, and healthcare costs is pivotal. </span><span style="font-family:"Calibri",sans-serif">Over time, the number of patients discharged on the same day has increased, without compromising the safety of the procedure. </span></span></span></span></p>
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