Feasibility and Safety of an Early Discharge Strategy after Low-Risk Acute Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention: The EDAMI Pilot Trial
Por:
Azzalini, L, Sole, E, Sans, J, Vila, M, Duran, A, Gil-Alonso, D, Santalo, M, Garcia-Moll, X, Sionis, A
Publicada:
1 ene 2015
Resumen:
Objectives: This pilot trial evaluated the feasibility and safety of an early discharge strategy (EDS: <= 72 h, followed by outpatient lifestyle interventions), in comparison with a conventional discharge strategy (CDS) for low-risk (Zwolle risk score <= 3) ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty. Methods: One hundred patients were randomized to an EDS (n = 54) or a CDS (n = 46). The primary end point was the feasibility of the EDS: (1) >= 70% of EDS patients discharged <= 72 h, (2) >= 70% visited by a nurse <= 7 days after discharge, (3) >= 70% with visits >= 3 by the nurse and (4) >= 70% visited by a cardiologist <= 3 months. Results: The mean age was 59.2 +/- 12.2 years and ejection fraction 54.0 +/- 7.1%. Eighty-six percent were male (12% diabetics). Vascular access was radial in 91%. Ischemic time was <= 4 h in 75%. Length of stay was shorter in EDS as compared with CDS (70.1 +/- 8.1 vs. 111.8 +/- 28.3 h, p < 0.001). EDS feasibility was: (1) 72.2%; (2) 81.5%; (3) 76.9%; (4) 72.2%. There were no adverse events or differences in intervention goals and quality of life between groups. Conclusions: An EDS in low-risk STEMI patients is feasible and seems to be safe. A shorter hospital stay could benefit patients and health care systems. (C) 2015 S. Karger AG, Basel
Filiaciones:
Azzalini, L:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Sole, E:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Sans, J:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Vila, M:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Duran, A:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Gil-Alonso, D:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Santalo, M:
Hosp Santa Creu & Sant Pau, Emergency Dept, Step Down Unit, ES-08025 Barcelona, Spain
Garcia-Moll, X:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
Sionis, A:
Hosp Santa Creu & Sant Pau, Dept Cardiol, ES-08025 Barcelona, Spain
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