PMID- 19033010
OWN - NLM
STAT- MEDLINE
DCOM- 20081216
LR  - 20220316
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 156
IP  - 6
DP  - 2008 Dec
TI  - Ambulatory discharge after transradial coronary intervention: Preliminary US 
      single-center experience (Same-day TransRadial Intervention and Discharge 
      Evaluation, the STRIDE Study).
PG  - 1141-6
LID - 10.1016/j.ahj.2008.07.018 [doi]
AB  - BACKGROUND: Although the safety and cost-effectiveness of same-day discharge 
      after uncomplicated transradial percutaneous coronary intervention (TR-PCI) is 
      well established in Europe and Asia, such data are not available for US patients. 
      METHODS: All patients who underwent TR-PCI at our high-volume US medical center 
      between 2004 and 2007 were included in this study. The primary end point was 
      in-hospital adverse clinical outcomes between 6 and 24 hours postprocedure. 
      RESULTS: A total of 450 patients were included in this study (aged 59 +/- 11 
      years). Of these, 13% were female, 27% were diabetic, 6% had peripheral vascular 
      disease, and 5% had chronic kidney disease. Procedural indications included 
      stable angina (49%), unstable angina (31%), non-ST elevation myocardial 
      infarction (NSTEMI) (17%), and ST elevation myocardial infarction (STEMI) (3%). 
      All patients received an intra-arterial cocktail of heparin, verapamil, and 
      nitroglycerin, and 13% of patients received glycoprotein IIb/IIIa inhibitors. 
      Seven percent of patients had 3-vessel disease, 3% had bypass grafts stenoses, 
      and 20% had class B(2)/C lesions. Procedural success rate was 96%. A total of 24 
      (5.3%) postprocedural complications were observed; however, none occurred between 
      hours 6 to 24, the time differential between same-day and next-day discharge. 
      Thirteen patients (2.9%) experienced significant complications within the first 6 
      hours (MI, urgent repeat revascularization, and ventricular tachycardia). Eleven 
      (2.4%) spontaneously resolved minor access complications developed. There were 12 
      same-day discharges according to the operators' discretion; none required 
      readmission. CONCLUSIONS: Although a low incidence of complications did occur, 
      none would have been impacted by same-day discharge. Those observed before 6 
      hours would have prevented early discharge, and those occurring after 24 hours 
      would have been unaffected by routine next-day discharge. This observational 
      study demonstrated the safety and feasibility for a prospective evaluation of 
      ambulatory TR-PCI in an American practice setting.
FAU - Jabara, Refat
AU  - Jabara R
AD  - Saint Joseph's Cardiovascular Research Institute, Saint Joseph's Hospital of 
      Atlanta, Atlanta, GA 30342, USA. rjabara@sjha.org
FAU - Gadesam, Radhika
AU  - Gadesam R
FAU - Pendyala, Lakshmana
AU  - Pendyala L
FAU - Chronos, Nicolas
AU  - Chronos N
FAU - Crisco, Larry V
AU  - Crisco LV
FAU - King, Spencer B
AU  - King SB
FAU - Chen, Jack P
AU  - Chen JP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20081009
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Academic Medical Centers
MH  - Aged
MH  - Ambulatory Surgical Procedures/*economics
MH  - Angina Pectoris/economics/*therapy
MH  - Angina, Unstable/economics/*therapy
MH  - Angioplasty, Balloon, Coronary/*economics/methods
MH  - Comorbidity
MH  - Cost-Benefit Analysis
MH  - *Electrocardiography
MH  - Feasibility Studies
MH  - Female
MH  - Humans
MH  - Length of Stay/economics
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/economics/*therapy
MH  - Patient Readmission/economics/statistics & numerical data
MH  - Postoperative Complications/economics/etiology/therapy
MH  - Prospective Studies
MH  - Radial Artery
EDAT- 2008/11/27 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/11/27 09:00
PHST- 2008/04/28 00:00 [received]
PHST- 2008/07/19 00:00 [accepted]
PHST- 2008/11/27 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/11/27 09:00 [entrez]
AID - S0002-8703(08)00651-0 [pii]
AID - 10.1016/j.ahj.2008.07.018 [doi]
PST - ppublish
SO  - Am Heart J. 2008 Dec;156(6):1141-6. doi: 10.1016/j.ahj.2008.07.018. Epub 2008 Oct 
      9.