Clinical outcomes of patients undergoing elective percutaneous coronary intervention with same-day discharge. Ten-year follow-up

Background Same-day discharge for percutaneous coronary interventions is an attractive and safe strategy. Observational and randomized data show equivalent results as compared to overnight observation. In addition, it ensues great savings for the healthcare system. Nevertheless, in Brazil, this approach is underused. The objective of this study was to describe the characteristics and outcomes of patients undergoing percutaneous coronary intervention with same-day discharge. Methods A single-center study with patients who underwent selected procedures, uneventful, discharged on the same day. Clinical and angiographic characteristics were described. Major cardiovascular events and complications were analyzed, reported, and compared to a historical cohort. Results A total of 413 patients were included, mean age of 64±10 years. After a 30-day follow-up, no major cardiovascular event was observed in selected patients submitted to the same-day discharge strategy. In addition, we found an increase in clinical and angiographic complexity as compared to the previous series, which did not translate to rise in adverse outcomes. Conclusion Uncomplicated percutaneous coronary interventions, with same-day discharge, are safe among appropriately selected patients, encouraging further adoption of this approach.

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Same-day discharge after elective percutaneous coronary intervention: A single center experience

Revista Portuguesa de Cardiologia (English Edition) ◽

10.1016/j.repce.2019.10.002 ◽

2020 ◽

Vol 39 (8) ◽

pp. 443-449

Author(s):

Alberto Rodrigues ◽

Mariana Silva ◽

Carla Almeida ◽

Francisco Castro Ferreira ◽

Gustavo Pires de Morais ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Intervention ◽

Single Center ◽

Elective Percutaneous Coronary Intervention ◽

Single Center Experience ◽

Percutaneous Coronary ◽

Same Day Discharge

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Growth differentiation factor 15 and the risk of cardiovascular events in patients with atrial fibrillation after elective percutaneous coronary intervention

Russian Journal of Cardiology ◽

10.15829/1560-4071-2021-4457 ◽

2021 ◽

Vol 26 (7) ◽

pp. 4457

Author(s):

E. N. Krivosheeva ◽

E. S. Kropacheva ◽

A. B. Dobrovolsky ◽

E. V. Titaeva ◽

E. P. Panchenko

Keyword(s):

Atrial Fibrillation ◽

Percutaneous Coronary Intervention ◽

Cardiovascular Events ◽

Coronary Intervention ◽

Growth Differentiation Factor 15 ◽

Elective Percutaneous Coronary Intervention ◽

Percutaneous Coronary ◽

D Dimer

Aim. To study the predictive value of growth differentiation factor 15 (GDF-15) in patients with atrial fibrillation (AF) after elective percutaneous coronary intervention (PCI).Material and methods. The study included 150 patients (men, 69,3%) with AF receiving direct oral anticoagulants in combination with two (89,3%) or one antiplatelet agent (10,7%) after elective PCI. Median age was 71,0 [interquartile range, 66,0; 77,0] years. The median follow-up was 11,5 months [interquartile range, 8,0; 12,0]. The efficacy endpoint was the sum of cardiovascular events (CVEs), including cardiovascular death, ischemic stroke, venous thromboembolism, peripheral arterial thrombosis, acute coronary syndrome, and the need for emergency PCI. The safety endpoint was considered to be BARC type 2-5 bleeding. Prior to PCI, blood plasma samples were taken from patients to determine GDF-15 and D-dimer by enzyme immunoassay.Results. The incidence of CVEs was 16%. The incidence of BARC type 2-5 bleeding was 24,7%. The median GDF-15 level was 1270,0 pg/ml [953,0; 1778,0]. According to multiple regression, the GDF-15 level is associated with D-dimer (t=3,20; p=0,0018), diabetes (t=3,97; p=0,0001) and SYNTAX score II (t=4,77; p<0,0001). In patients with single-vessel coronary artery disease, the GDF-15 level was significantly lower than in patients with three-vessel disease (p=0,0119). According to the ROC analysis, a GDF-15 >1191 pg/ml (p=0,0076) increases the likelihood of CVE (area under the curve, 0,647; confidence interval (CI), 0,5650,723). According to Kaplan-Meier survival curves, significant differences were found in terms of absence of CVEs during the follow-up period between the groups of patients with a GDF-15 >1191 and those with GDF-15 <1191 pg/ml (76% vs 94%, p=0,0032; relative risk, 4,36; CI 1,50-7,48). The relationship of GDF-15 level with BARC type 2-5 bleeding was not revealed.Conclusion. GDF-15 is a novel marker of CVE in AF patients after elective PCI.

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