Background: Same-day discharge after PCI is more convenient to patients and has logistic and economic advantages. The data on the outcome of same-day discharge after PCI for acute coronary syndrome (ACS) in the middle east is sparse.
Methods: From January 2016 till January 2017, we enrolled patients with ACS who had PCI.We allowed same-say discharge in patients provided they were not in cardiogenic shock and/or acute pulmonary edema. Same-day discharge was not allowed also in patients with GRACE score >150, patients with severe chronic kidney disease and patients with complicated PCI procedure,We also excluded patients with vascular access complications.We examined patients at one month for the occurrence of MACE including death, MI, stroke, unplanned readmission or unplanned repeat revascularization.
Results: 75 ACS patients could be discharged on the same day after PCI. The mean age was 57.7±10.4 years and 82.6% were males. The prevalence of hypertension, diabetes, and smoking was 68%, 60%, and 65.3% respectively. The mean GRACE score was 85+18 and 29.3% of patients had elevated cardiac troponin. The mean EF was 54±10%. The vascular access was radial in 88%, ulnar in 2.7% and femoral in 9.3% of patients. 56% of procedures were for single vessel and 44% were for two-vessel or multi-vessel disease. PCI was performed for the left main in 5.3%, LAD territory in 52%, Cx territory in 30.1%, RCA territory in 32%, and surgical grafts in 2.7%. Five patients (6.7%) had PCI for CTO. Drug-eluting stents were deployed in 97.3% and 4% had balloon angioplasty with drug-coated balloons. The observation time after PCI was 5.8+1.3 hours. At 30 days there were no deaths, MI or repeat revascularization.
Conclusion: In a mixed population of ACS patients including patients with elevated troponin, left main disease, multivessel disease and CTO, same-day discharge after uncomplicated PCI is feasible and is not associated with worse outcome.
