PMID- 12622436
OWN - NLM
STAT- MEDLINE
DCOM- 20030318
LR  - 20190826
IS  - 0021-4868 (Print)
IS  - 0021-4868 (Linking)
VI  - 44
IP  - 1
DP  - 2003 Jan
TI  - The feasibility and safety of early discharge for low risk patients with acute 
      myocardial infarction after successful direct percutaneous coronary intervention.
PG  - 41-9
AB  - There is a lack of consensus among cardiologists regarding the length of time 
      patients should be hospitalized after an uncomplicated acute myocardial 
      infarction (AMI) and successful direct percutaneous coronary intervention 
      (d-PCI). The purpose of this study was to evaluate the feasibility and safety of 
      early discharge (discharge <4 days after the procedure) for low risk patients 
      with AMI who underwent successful d-PCI. From May 1996 through December 2001, 
      d-PCI was performed in 898 consecutive patients with AMI. Of these 898 patients, 
      463 (51.6%) were stratified to be at low risk. Lower risk was defined as: (1) 
      Killip classification < or = 2 on admission; (2) the infarct-related artery 
      achieved normal blood flow without recurrent ischemia or reinfarction in the 
      first 24 hours; (3) no mechanical or electrical complications after d-PCI. (4) no 
      acute renal failure, acute stroke, or major bleeding complication; (5) no 
      advanced congestive heart failure (defined as > or = New York Heart Association 
      functional class 3); and (6) no sepsis. Patients who were discharged <4 days 
      after undergoing the procedure were enrolled in group 1 (n = 266). Patients who 
      were discharged > or = 4 days after undergoing the procedure were enrolled in 
      group 2 (n = 197). Univariate analysis demonstrated that group 2 patients had a 
      significantly longer hospital stay (P = 0.0001) than group 1 patients. At the 
      first 30-day follow-up examination, there were no significant differences in the 
      combined major cardiac events (death, recurrent isehemia, reinfarction, 
      revascularization. or advanced congestive heart failure) between the group 1 and 
      group 2 patients (1.50% vs 1.52%, P = 0.92). There were also no significant 
      differences in the combined major noncardiac complications (acute stroke, acute 
      renal failure, bleeding complications requiring blood transfusion, vascular 
      sequelae, or sepsis) between the group 1 and group 2 patients (1.13% vs 0.51%. P 
      = 0.89). Early discharge was feasible in a majority of the patients who 
      experienced AMI and were at lower risk 24 hours after successful d-PCI. Thus, the 
      patients had a shortened hospital stay and no increased risk.
FAU - Yip, Hon-Kan
AU  - Yip HK
AD  - Division of Cardiology, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung 
      Hsien, Taiwan, ROC.
FAU - Wu, Chiung-Jen
AU  - Wu CJ
FAU - Chang, Hsueh-Wen
AU  - Chang HW
FAU - Hang, Chi-Ling
AU  - Hang CL
FAU - Wang, Chao-Ping
AU  - Wang CP
FAU - Yang, Cheng-Hsu
AU  - Yang CH
FAU - Hung, Wei-Chin
AU  - Hung WC
FAU - Yu, Ten-Hung
AU  - Yu TH
FAU - Yeh, Kuo-Ho
AU  - Yeh KH
FAU - Chua, Sarah
AU  - Chua S
FAU - Fu, Morgan
AU  - Fu M
FAU - Chen, Mien-cheng
AU  - Chen MC
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Jpn Heart J
JT  - Japanese heart journal
JID - 0401175
SB  - IM
MH  - Aged
MH  - Angioplasty, Balloon, Coronary/*rehabilitation
MH  - Coronary Angiography
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - *Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*therapy
MH  - Patient Discharge
MH  - Risk Assessment
MH  - Safety
MH  - Stents
EDAT- 2003/03/08 04:00
MHDA- 2003/03/19 04:00
CRDT- 2003/03/08 04:00
PHST- 2003/03/08 04:00 [pubmed]
PHST- 2003/03/19 04:00 [medline]
PHST- 2003/03/08 04:00 [entrez]
AID - 10.1536/jhj.44.41 [doi]
PST - ppublish
SO  - Jpn Heart J. 2003 Jan;44(1):41-9. doi: 10.1536/jhj.44.41.