Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention
Background: The discharge of uncomplicated patients with ST-segment-elevation myocardial infarction (STEMI) within 48 to 72 hours has been proven safe and feasible. The safety and feasibility of the very early discharge (≤48 h) of such patients, especially during the COVID-19 pandemic with limited b...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2021-07-01
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| Series: | Journal of Tehran University Heart Center |
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| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/1508 |
| _version_ | 1828865018695778304 |
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| author | Seyed Kianoosh Hosseini Behshad Naghshtabrizi Farzad Emami Amirhossein Yazdi Nima Naghshtabrizi Sara Zebarjadi |
| author_facet | Seyed Kianoosh Hosseini Behshad Naghshtabrizi Farzad Emami Amirhossein Yazdi Nima Naghshtabrizi Sara Zebarjadi |
| author_sort | Seyed Kianoosh Hosseini |
| collection | DOAJ |
| description | Background: The discharge of uncomplicated patients with ST-segment-elevation myocardial infarction (STEMI) within 48 to 72 hours has been proven safe and feasible. The safety and feasibility of the very early discharge (≤48 h) of such patients, especially during the COVID-19 pandemic with limited bed availability and infection risk, have yet to be evaluated.
Methods: In this cohort study on 108 patients with STEMI who presented to Farshchian Heart Center between February and May 2020, 30 patients received fibrinolysis and 78 were scheduled for emergent coronary angiography. One patient had no coronary obstruction, 3 underwent emergent surgery, and 3 had high-risk features mandating a prolonged stay. The remaining patients were assigned to either Group A (≤48 h) or Group B (>48 h) regarding hospital discharge. Demographic, angiographic, procedural, and outcome data were compared between the 2 groups.
Results: Group A consisted of 51 patients, including 7 women (13.7%), at a mean age of 62.74±12.35 years, and Group B comprised 20 patients, including 4 women (20.0%), at a mean age of 65.20±12.82 years. The mean hospital length of stay was 38.02±9.15 hours in Group A and 88.20±23.31 hours in Group B (P<0.001). The mean stent diameter was smaller in Group B (3.19±0.34 mm vs 2.96±0.29 mm; P=0.008). Demographic, angiographic, procedural, and outcome data, including the rates of in-hospital, 1-week, and 1-month mortality, were similar between the 2 groups.
Conclusion: This study shows that a hospital discharge in less than 48 hours in low-risk patients with STEMI is safe and feasible. The potential advantages of this approach in the COVID-19 pandemic should be balanced against its risks. |
| first_indexed | 2024-12-13T04:19:40Z |
| format | Article |
| id | doaj.art-184e6aae81ef4bcba3cd6e1b194d3f47 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-12-13T04:19:40Z |
| publishDate | 2021-07-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-184e6aae81ef4bcba3cd6e1b194d3f472022-12-21T23:59:47ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712021-07-0116310.18502/jthc.v16i3.8188Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary InterventionSeyed Kianoosh Hosseini0Behshad Naghshtabrizi1Farzad Emami2Amirhossein Yazdi3Nima Naghshtabrizi4Sara Zebarjadi5Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran.Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran.Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran.Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran.Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran.Farshchian Heart Center, Hamadan University of Medical Sciences, Hamadan, Iran.Background: The discharge of uncomplicated patients with ST-segment-elevation myocardial infarction (STEMI) within 48 to 72 hours has been proven safe and feasible. The safety and feasibility of the very early discharge (≤48 h) of such patients, especially during the COVID-19 pandemic with limited bed availability and infection risk, have yet to be evaluated. Methods: In this cohort study on 108 patients with STEMI who presented to Farshchian Heart Center between February and May 2020, 30 patients received fibrinolysis and 78 were scheduled for emergent coronary angiography. One patient had no coronary obstruction, 3 underwent emergent surgery, and 3 had high-risk features mandating a prolonged stay. The remaining patients were assigned to either Group A (≤48 h) or Group B (>48 h) regarding hospital discharge. Demographic, angiographic, procedural, and outcome data were compared between the 2 groups. Results: Group A consisted of 51 patients, including 7 women (13.7%), at a mean age of 62.74±12.35 years, and Group B comprised 20 patients, including 4 women (20.0%), at a mean age of 65.20±12.82 years. The mean hospital length of stay was 38.02±9.15 hours in Group A and 88.20±23.31 hours in Group B (P<0.001). The mean stent diameter was smaller in Group B (3.19±0.34 mm vs 2.96±0.29 mm; P=0.008). Demographic, angiographic, procedural, and outcome data, including the rates of in-hospital, 1-week, and 1-month mortality, were similar between the 2 groups. Conclusion: This study shows that a hospital discharge in less than 48 hours in low-risk patients with STEMI is safe and feasible. The potential advantages of this approach in the COVID-19 pandemic should be balanced against its risks.https://jthc.tums.ac.ir/index.php/jthc/article/view/1508Myocardial infarctionDischarge planningCoronavirusPercutaneous transluminal coronary angioplasty |
| spellingShingle | Seyed Kianoosh Hosseini Behshad Naghshtabrizi Farzad Emami Amirhossein Yazdi Nima Naghshtabrizi Sara Zebarjadi Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention Journal of Tehran University Heart Center Myocardial infarction Discharge planning Coronavirus Percutaneous transluminal coronary angioplasty |
| title | Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention |
| title_full | Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention |
| title_fullStr | Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention |
| title_full_unstemmed | Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention |
| title_short | Very Early Discharge of Patients with ST-Segment-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention |
| title_sort | very early discharge of patients with st segment elevation myocardial infarction after primary percutaneous coronary intervention |
| topic | Myocardial infarction Discharge planning Coronavirus Percutaneous transluminal coronary angioplasty |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/1508 |
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