EARLY DISCHARGE (48–72 HOURS) AFTER ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION: INTERIM RESULTS OF THE OPEN, RANDOMIZED, MONOCENTRIC STUDY

Kamil Novobílský, Radim Kryza, Petr Černý, Ivo Horák, Vladimír Kaučák, Jan Mrózek, Roman Štípal

Abstract


Authors present the interim analysis of open, prospective, randomized study, comparing the strategy of early (48–72 hours) and standard (after 72 hours) discharge in low risk patients after myocardial infarction with ST-segment elevation (STEMI), treated with successful primary percutaneous coronary intervention (PCI). 91 patients (22.5% of all STEMI patients admitted within the period between October 15, 2013 and October 6, 2015), who fulfilled given inclusion criteria of low risk, were randomly assigned to two groups in a 1:1 ratio. The primary end point was the composite of death, myocardial infarction (MI), unstable angina, stroke, unplanned rehospitalization, repeated target vessel revascularization, stent thrombosis within 90-day follow-up. The length of stay was significantly shorter in the intervention group (63.0 ± 7.8 h vs. 91.1 ± 11.9 h, p < 0.0001). The primary end point at 3 months occurred in 3 patients assigned to intervention group as compared to 2 patients assigned to control group (6.4% vs. 4.5%, p = 1.0 for non-inferiority). There were no significant differences in the incidence rates of individual components of the primary end point at 90 days. Presented interim data of the study support the claim that early discharge (48–72 hours) in selected patients after STEMI, treated with successful primary PCI, is possible and safe, with the results comparable to the later discharge, realized in compliance with current guidelines and present everyday clinical practice.


Keywords


myocardial infarction with ST-segment elevation; primary percutaneous coronary intervention; low risk; early discharge; feasibility; safety

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ISSN 0301-5491 (Print)
ISSN 2336-5552 (Online)
Published by the Czech Society for Biomedical Engineering and Medical Informatics and the Faculty of Biomedical Engineering, Czech Technical University in Prague.