Vivek Raj Singh1, Balachander Jayaraman1, Santhosh Satheesh1, Ajith Ananthakrishna Pillai2. 1. Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India. 2. Associate Professor, Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry 605006, India. Electronic address: ajithanantha@gmail.com.
Abstract
BACKGROUND: The concept of day care based coronary angioplasty might be frugal especially in countries like India where epidemic of coronary disease is enduring and healthcare delivery systems are limited. Published literature addressing the feasibility and safety of day care percutaneous coronary interventions (PCI) is lacking from our country. OBJECTIVES: To study the safety and outcomes in stable cardiac patients undergoing day care coronary angioplasty. METHODS: A single centre nonrandomized active controlled trial of patients undergoing elective transradial coronary angioplasty and same day discharge after triaging was compared with a conventional arm of hospital overnight stay. RESULTS: Fifty six patients with stable coronary artery disease underwent day care angioplasty. There were no major immediate adverse cardiac and cerebral events noted in the first 24 h. The procedural result followed by a 6-h observation period allowed adequate triage of patients to same-day discharge or to extended clinical observation. Apart from one possible stent thrombosis on day 3 in the treatment arm where the patent received fibrinolytic treatment in a local hospital, there were no major adverse cardiac or cerebral vascular events in the study group. The six month clinical follow up in the day care procedure group was also unevenful for any major adverse cardiac events. CONCLUSION: The study albeit small shows the feasibility and safety of day care PCI in the Indian scenario. It did not lead to additional complications compared with overnight stay. Triage of patients for an extended observation period can be performed adequately on the basis of clinical and procedural criteria.
BACKGROUND: The concept of day care based coronary angioplasty might be frugal especially in countries like India where epidemic of coronary disease is enduring and healthcare delivery systems are limited. Published literature addressing the feasibility and safety of day care percutaneous coronary interventions (PCI) is lacking from our country. OBJECTIVES: To study the safety and outcomes in stable cardiac patients undergoing day care coronary angioplasty. METHODS: A single centre nonrandomized active controlled trial of patients undergoing elective transradial coronary angioplasty and same day discharge after triaging was compared with a conventional arm of hospital overnight stay. RESULTS: Fifty six patients with stable coronary artery disease underwent day care angioplasty. There were no major immediate adverse cardiac and cerebral events noted in the first 24 h. The procedural result followed by a 6-h observation period allowed adequate triage of patients to same-day discharge or to extended clinical observation. Apart from one possible stent thrombosis on day 3 in the treatment arm where the patent received fibrinolytic treatment in a local hospital, there were no major adverse cardiac or cerebral vascular events in the study group. The six month clinical follow up in the day care procedure group was also unevenful for any major adverse cardiac events. CONCLUSION: The study albeit small shows the feasibility and safety of day care PCI in the Indian scenario. It did not lead to additional complications compared with overnight stay. Triage of patients for an extended observation period can be performed adequately on the basis of clinical and procedural criteria.
Authors: Kimberly M Brayton; Vishal G Patel; Christopher Stave; James A de Lemos; Dharam J Kumbhani Journal: J Am Coll Cardiol Date: 2013-04-23 Impact factor: 24.094
Authors: S G Ellis; M G Vandormael; M J Cowley; G DiSciascio; U Deligonul; E J Topol; T M Bulle Journal: Circulation Date: 1990-10 Impact factor: 29.690
Authors: Chuntao Wu; Edward L Hannan; Gary Walford; John A Ambrose; David R Holmes; Spencer B King; Luther T Clark; Stanley Katz; Samin Sharma; Robert H Jones Journal: J Am Coll Cardiol Date: 2006-01-04 Impact factor: 24.094
Authors: A A Ziakas; B P Klinke; C R Mildenberger; D E Fretz; E M B Williams; F R D Kinloch; G J D Hilton j Journal: Am Heart J Date: 2003-10 Impact factor: 4.749