PMID: 8606274Mar 1, 1996Paper

Early discharge in the thrombolytic era: an analysis of criteria for uncomplicated infarction from the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) trial

Journal of the American College of Cardiology
L K NewbyE J Topol

Abstract

This study sought to readdress the definition of uncomplicated myocardial infarction and to apply clinical criteria for early discharge of such patients in the thrombolytic era. Previous studies proposed early hospital discharge at day 7 to 10 after acute myocardial infarction. The potential for earlier discharge of patients with uncomplicated infarction after thrombolysis remains undemonstrated. We defined "uncomplicated infarction" a priori as the absence of death, reinfarction, ischemia, stroke, shock, heart failure (Killip class > 1), bypass surgery, balloon pumping, emergency catheterization or cardioversion or defibrillation in the first 4 hospital days. We applied this definition to 41,021 patients in the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO-I) trial. We examined death at 30 days and 1 year and rates of in-hospital reinfarction, heart failure, recurrent ischemia, shock and stroke in the uncomplicated and complicated groups created by application of our definition. We also assessed lengths of hospital and cardiac care unit stay. Application of our clinical criteria yielded 23,497 (57.3%) patients in the uncomplicated group at day 4 with a very low risk of death and in-hospital...Continue Reading

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Citations

Sep 19, 1998·Controlled Clinical Trials·G L KnatterudR O'Neill
Apr 13, 2001·Journal of the American College of Cardiology·P BogatyJ R Boudreault
Apr 8, 1998·Journal of the American College of Cardiology·R G Favaloro
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Sep 6, 2018·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Kamil NovobilskyRadim Kryza
Apr 20, 2007·The Cochrane Database of Systematic Reviews·H HerknerM Müllner
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