Same day percutaneous coronary intervention discharge: From exception to expectation

Résumé fourni par la source

Same day discharge after elective percutaneous coronary intervention (PCI) is increasingly adopted, particularly with transradial access, however long-term safety evidence has been limited.Klocek et al recently published a study in the World Journal of Cardiology provide timely real-world data from a single ambulatory surgical center: 787 consecutive PCIs (2018-2023) with a median discharge time of 150 minutes.Early outcomes were reassuring: Within 24 hours there were no deaths, strokes, emergent coronary artery bypass grafting, transfers for overnight care, or hospitalizations; by 30 days, unplanned cardiovascular hospitalizations occurred in 0.7% and there were no deaths or strokes.Two-year events remained low: Death 1.93%, myocardial infarction 0.85%, target vessel revascularization 7.62%, and stroke 0.17%.Subgroup outcomes in higher-risk anatomy -25 left main and 332 left anterior descending (115 proximal) procedures -were reassuring but based on small numbers and remain hypothesisgenerating rather than confirmatory, particularly for left main disease.Femoral cases showed higher two-year target vessel revascularization (21.84% vs 5.85%; P < 0.001) without differences in death or myocardial infarction, reflecting greater baseline comorbidity rather than access site alone.Interpreted alongside the randomized and consensus evidence that preceded it, including the 2018 Society for Cardiovascular Angiography and Interventions shift from anatomy-based exclusions to milestone-based discharge readiness, this hypothesis-generating study supports the feasibility of very early discharge after PCI in experienced centers with structured follow-up and standardized protocols.Nevertheless, its retrospective, single-center design, absence of an inpatient comparator, and capture of unplanned hospitalizations only to 30 days temper conclusions.Future multicenter randomized trials and standardized postdischarge pathways are warranted.

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