Author + information
- Gerardo Rodriguez-Araujo,
- William Rollefson,
- Mehmet Cilingiroglu,
- David Mego,
- Ian Cawich,
- Vasili Lendel,
- Andre Paixao,
- Konstantinos Marmagkiolis,
- Daniel Sherbet and
- Patrick Flaherty
Background: Transradial (TR) PCIs have been progressively increasing over the last decade in the US. Previous studies have shown that same-day discharge after elective PCI is associated with similar safety compared to overnight observation. This study sought to assess the clinical and financial impact of early discharge in patients undergoing TR-PCI.
Methods: Patients undergoing elective TR-PCI were prospectively included in our study. Timing of discharge was determined by the treating physician. Group A patients were discharged the same day while group B patients were kept overnight. Demographic data, procedural characteristics, and adverse outcomes were recorded. Outcomes included 30 day- MACE and procedure- related complications as well as total operative costs in patients from both groups. Propensity score matching for patient demographics, coronary symptoms and procedure indicators was used to compare both groups.
Results: The charts of 852 patients (429 in group A and 423 in group B) were reviewed. Propensity score matched groups were compared (245 in group A and 245 in group B). Groups A and B had no significant differences in any of the components of the clinical outcome; procedural complications (3.7% vs 2.5%, p=0.43), re-hospitalization (4.1% vs 4.1%, p=0.92), re-intervention(2.4% vs 2.1%, p=0.77), myocardial infarction (0% vs 0.08%, p=0.15), stroke (0% vs 0%, p=1.0) and death of any cause (0% vs 0%, p=1.0). Group A patients had a significant lower procedure- related cost than overnight stay patients($3,346.45 vs $4,681.99, p<0.0001) as well as the 30 day post procedure- associated cumulative costs/ total operating costs ($4,493.22 vs $7,112.21, p<0.0001).
Conclusions: Same-day discharge after elective TR-PCI is a safe and feasible clinical practice for cardiologists. It results in significant expense reduction to the US healthcare system.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-326
- 2017 American College of Cardiology Foundation