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Abstract

Title
A PILOT STUDY: SAME DAY DISCHARGE (SDD) POST PERCUTANEOUS CORONARY INTERVENTION (PCI) IN SINGAPORE
Type
Free Paper Session 5
Theme
ACC Asia & SCS 32nd Annual Scientific Meeting
Topic
Invasive Diagnostic & Interventional Cardiology

Authors

Main Author
Randal, Jun Bang Low1
Presenting Author
Randal, Jun Bang Low1
Co-Author
Deanna Khoo1
Hee Hwa Ho1
Huimin Li1
Yu Ping Lim1
Christina HH Tan1
Jun Hui Chai1
Paul JL Ong1

Authors' Institution

Department / Institution / Country
Cardiology / Tan Tock Seng Hospital / Singapore1
Content
Objective(s)

PCI is considered standard of care for a wide variety of indications in modern Cardiology, and has become a widely performed procedure in Singapore. By convention, patients are observed overnight in telemetry units before discharge.
We at the Tan Tock Seng Hospital Invasive Cardiac Laboratory conducted a prospective observational pilot study to assess the safety and efficacy of the first SDD program in Singapore.
Material and Method
Based on the following inclusion criteria, purposive sampling method was adopted to identify suitable candidates.

 

Patients’ criteria

Intra-procedure criteria

Post-procedure criteria

Age≤65

Transradial/groin closure devices

No GP IIb/IIIa Inhibitors infusion

eGFR>60

Single-vessel PCI

No hemodynamic instability

Hb>10

Contrast<250ml

No vascular complication

Platelets>150

No para-procedure complications

No rise in CKMB>3x ULN

LVEF>40%

Stent≤48mm

No ECG changes/arrhythmias

Caregiver available

  

Selected by primary operator/Patient agreement
Routine post-PCI investigations including blood work and electrocardiogram were done 4 hours post-PCI, and patients were monitored for a total of 6 hours.
Patients were followed-up with telephone calls at post-PCI day-1, 3-months and 6-months. Pre-defined adverse outcomes that were monitored included: death from cardiac cause, target lesion failure, myocardial infarction, serious vascular complications, major bleeding, acute kidney injury, and readmission from cardiac cause.
Result(s)
32 patients were followed-up for 1 year. 1 patient was re-admitted 6 weeks post-PCI for mild congestive heart failure. Another patient presented to the Emergency Department for angina within the first month but did not require admission.
Otherwise, there was no occurrence of any of the other above-stated adverse events. There was also overall positive reception from patients.
Conclusion
SDD post-PCI in the elective setting appears to be safe in this highly selected group of patients. The benefits of SDD include decreased length of hospital stay with reduced cost, maximization of healthcare resources and improved patient satisfaction.
Further evaluation of this practice should be carried out in real world patients.
Keywords: discharge;elective;percutaneous;coronary;intervention
Requires Audio or Video system for Presentation?: Yes Back