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vol.90 número3Actitudes y prácticas clínicas en la insuficiencia cardiaca en médicos de ArgentinaCaracterísticas de pacientes hospitalizados en Unidad Coronaria del Hospital Provincial Neuquén por síndrome coronario agudo sin elevación del segmento ST (SCASEST) índice de autoresíndice de assuntospesquisa de artigos
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Revista argentina de cardiología

versão On-line ISSN 1850-3748

Resumo

DIONISIO, GABRIEL F. et al. Early Hospital Discharge (Within Six Hours) for Patients Undergoing Coronary Angioplasty. Rev. argent. cardiol. [online]. 2022, vol.90, n.3, pp.215-218.  Epub 01-Jun-2022. ISSN 1850-3748.  http://dx.doi.org/10.7775/rac.es.v90.i3.20515.

Background:

24-hour hospitalization is common practice in patients (P) who underwent scheduled coronary angioplasty (PCI). Previous experiences propose same-day discharge in selected P.

Methods:

Prospective, comparative, randomized, single-blind study. P aged 18 to 75 years were included as candidates for a scheduled radial-access PCI with the possibility of accessing the emergency system in less than 40 minutes. P with left ventricular ejection fraction <30%, creatinine >1.5 mg/dL, heart failure, chronic obstructive pulmonary disease, decompensated diabetes or very complex coronary anatomy were excluded. The population was divided in two groups (G). G 1: same-day discharge in 6 hours. G2: discharge the next day. Primary endpoint: death or need for rehospitalization within 24 hours of the procedure. Follow-up was carried out by phone the night of the procedure and the next morning, in person at 48 hours, and by telephone after a month, six months and a year. Continuous variables were expressed as median and their respective interquartile range, and qualitative variables as percentages.

Results:

80 P were randomized. Six P (7.5%) presented exclusion criteria during the procedure. There were no deaths or major cardiovascular events in either groups. At one year of follow-up, 3.75% of in-stent restenosis was detected. Troponin elevation was detected in 20 P (25%); 4 were P excluded due to complications during PCI, in the remaining 16 it had no clinical repercussion.

Conclusion:

In a population of patients between 55 and 75 years old, mostly male, with a high prevalence of previous myocardial infarction, and ventricular function depression, a scheduled radial-access PCI could be performed with same day discharge in 6 hours, with an adequate safety margin.

Palavras-chave : Angioplastia; Length of Stay; Time Factors; Patient Discharge.

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