Jun 1, 2020

Early vs late discharge in low-risk ST-elevation myocardial infarction patients treated with percutaneous coronary intervention: A systematic review and meta-analysis

Cardiovascular Revascularization Medicine : Including Molecular Interventions
Zain Ul Abideen AsadMazen Abu-Fadel

Abstract

For low-risk patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) the recommended optimal discharge timing is inconsistent in guidelines. The European Society of Cardiology guidelines recommend early discharge within 48-72 h, while the American College of Cardiology guidelines do not recommend a specific discharge strategy. In this systematic review and meta-analysis we compared outcomes with early discharge (≤3 days) versus late discharge (>3 days). Randomized controlled trials (RCTs) and observational studies were selected after searching MEDLINE and EMBASE database. Meta-analysis was stratified according to study design. Outcomes were reported as random effects risk ratios (RR) with 95% confidence intervals. Seven RCTs comprising 1780 patients and 4 observational studies comprising 39,288 patients were selected. The RCT-restricted analysis did not demonstrate significant differences in terms of all-cause mortality (RR, 0.97 [0.23-4.05]) and major adverse cardiac events (MACE) (RR, 0.84 [0.56-1.26]). Conversely, observational study restricted analysis showed that early vs late discharge strategy was associated with a reduction in all-cause mortality (RR, 0.40 [0.23-0.71]...Continue Reading

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Mentioned in this Paper

Major promastigote-associated transcript 1 protein, Leishmania major
Percutaneous Coronary Intervention
Adverse Event Associated With Cardiac Arrhythmia
Analysis
ST segment elevation myocardial infarction
Hospital Readmissions
Observational Study
Patient Discharge
Root Canal Therapy
Meta Analysis (Statistical Procedure)

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