Safety of primary PCI with early discharge? A comparative study of 36 vs > 36 hours primary PCI discharge protocol”.

Abstract

Objectives: In this study we aimed at establishing the safety of a very early discharge within 24 to 36 hours after a primary PCI. Study Design: Prospective Comparative study. Setting: Punjab Institute of Cardiology, Lahore. Period: July to December 2019. Material & Methods: We randomly assigned a ≤ 36 hours discharge protocol to the very low risk patients after a primary PCI. FASTEST score was used to identify the low risk group. Comparison was made at 30 days between early discharge and ordinary discharge low risk groups for outcomes like reinfarction, stent thrombosis (ST), target lesion revascularization (TLR), bleeding, stroke and death. Results: Among 329 very low risk primary PCI patients, 161 were randomly assigned to early discharge group and 168 to ordinary discharge group. The outcomes were similar at 01 month in early vs ordinary discharge groups. There was no significant difference in the rate of reinfarction (1.24% vs 1.79%, P value 0.68), ST (1.24% vs 1.19%, P values 0.96), TLR (1.24% vs 1.19%, P value 0.96) and bleeding (0.62% vs 0.59%, P value 0.97). There was no mortality or stroke. Conclusions: Using any of the scoring systems, very low risk patients should be routinely identified after primary PCI. Short term major adverse outcomes remain at a low and a very early discharge protocol can be safely implemented in this subgroup. In addition to saving health costs, this can be of particular value during outbreaks like COVID-19