eprintid: 10141668 rev_number: 18 eprint_status: archive userid: 608 dir: disk0/10/14/16/68 datestamp: 2022-01-11 14:12:07 lastmod: 2022-12-22 07:10:29 status_changed: 2022-01-11 14:12:07 type: article metadata_visibility: show creators_name: Rathod, KS creators_name: Comer, K creators_name: Casey-Gillman, O creators_name: Moore, L creators_name: Mills, G creators_name: Ferguson, G creators_name: Antoniou, S creators_name: Patel, R creators_name: Fhadil, S creators_name: Damani, T creators_name: Wright, P creators_name: Ozkor, M creators_name: Das, D creators_name: Guttmann, OP creators_name: Baumbach, A creators_name: Archbold, RA creators_name: Wragg, A creators_name: Jain, AK creators_name: Choudry, FA creators_name: Mathur, A creators_name: Jones, DA title: Early Hospital Discharge Following PCI for Patients With STEMI ispublished: pub divisions: UCL divisions: B02 divisions: D14 divisions: GA3 keywords: Early discharge, primary PCI, STEMI note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Background: Regional heart attack services have improved clinical outcomes following ST-segment elevation myocardial infarction (STEMI) by facilitating early reperfusion by primary percutaneous coronary intervention (PCI). Early discharge after primary PCI is welcomed by patients and increases efficiency of health care. Objectives: This study aimed to assess the safety and feasibility of a novel early hospital discharge pathway for low-risk STEMI patients. Methods: Between March 2020 and June 2021, 600 patients who were deemed at low risk for early major adverse cardiovascular events (MACE) were selected for inclusion in the pathway and were successfully discharged in <48 hours. Patients were reviewed by a structured telephone follow-up at 48 hours after discharge by a cardiac rehabilitation nurse and underwent a virtual follow-up at 2, 6, and 8 weeks and at 3 months. Results: The median length of hospital stay was 24.6 hours (interquartile range [IQR]: 22.7-30.0 hours) (prepathway median: 65.9 hours [IQR: 48.1-120.2 hours]). After discharge, all patients were contacted, with none lost to follow-up. During median follow-up of 271 days (IQR: 88-318 days), there were 2 deaths (0.33%), both caused by coronavirus disease 2019 (>30 days after discharge), with 0% cardiovascular mortality and MACE rates of 1.2%. This finding compared favorably with a historical group of 700 patients meeting pathway criteria who remained in the hospital for >48 hours (>48-hour control group) (mortality, 0.7%; MACE, 1.9%) both in unadjusted and propensity-matched analyses. Conclusions: Selected low-risk patients can be discharged safely following successful primary PCI by using a pathway that is supported by a structured, multidisciplinary virtual follow-up schedule. date: 2021-12-21 date_type: published official_url: https://doi.org/10.1016/j.jacc.2021.09.1379 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1911238 doi: 10.1016/j.jacc.2021.09.1379 lyricists_name: Patel, Riyaz lyricists_id: RSPAT27 actors_name: Stacey, Thomas actors_id: TSSTA20 actors_role: owner full_text_status: public publication: Journal of the American College of Cardiology volume: 78 number: 25 pagerange: 2550-2560 citation: Rathod, KS; Comer, K; Casey-Gillman, O; Moore, L; Mills, G; Ferguson, G; Antoniou, S; ... Jones, DA; + view all <#> Rathod, KS; Comer, K; Casey-Gillman, O; Moore, L; Mills, G; Ferguson, G; Antoniou, S; Patel, R; Fhadil, S; Damani, T; Wright, P; Ozkor, M; Das, D; Guttmann, OP; Baumbach, A; Archbold, RA; Wragg, A; Jain, AK; Choudry, FA; Mathur, A; Jones, DA; - view fewer <#> (2021) Early Hospital Discharge Following PCI for Patients With STEMI. Journal of the American College of Cardiology , 78 (25) pp. 2550-2560. 10.1016/j.jacc.2021.09.1379 <https://doi.org/10.1016/j.jacc.2021.09.1379>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10141668/3/Patel_24h%20discharge%20manuscript_final.pdf