TY - JOUR
T1 - Same day discharge versus overnight observation following chronic total occlusion percutaneous coronary intervention
T2 - Insights from the PROGRESS-CTO registry
AU - the PROGRESS-CTO investigators
AU - Simsek, Bahadir
AU - Khatri, Jaikirshan
AU - Young, Laura
AU - Kostantinis, Spyridon
AU - Karacsonyi, Judit
AU - Rempakos, Athanasios
AU - Alaswad, Khaldoon
AU - Jaffer, Farouc A.
AU - Doshi, Darshan
AU - Gorgulu, Sevket
AU - Goktekin, Omer
AU - Kerrigan, Jimmy
AU - Haddad, Elias V.
AU - Rinfret, Stephane
AU - Jaber, Wissam A.
AU - Nicholson, William
AU - Krestyaninov, Oleg
AU - Khelimskii, Dimitrii
AU - Choi, James W.
AU - Patel, Taral N.
AU - Jefferson, Brian K.
AU - Bradley, Steven M.
AU - Rao, Sunil V.
AU - Rangan, Bavana V.
AU - Allana, Salman S.
AU - Sandoval, Yader
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
AU - Poommipanit, Paul B.
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background: Same day discharge (SDD) following chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We evaluated the clinical, angiographic, and procedural characteristics of patients discharged the same day versus those kept for overnight observation in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO, NCT02061436). Results: Of the 7181 patients who underwent CTO PCI, 943 (13%) had SDD. The SDD rate increased from 3% in 2015 to 21% in 2022. Patients with SDD were less likely to have a history of heart failure (21% vs. 26%, p = 0.005), chronic lung disease (10% vs. 15%, p = 0.001), or anemia (12% vs. 19%, p < 0.001). Technical success (87% vs. 88%, p = 0.289) was similar, but in-hospital major adverse cardiovascular events (0.0% vs. 0.4%, p = 0.041) were lower in SDD. In multivariable logistic regression analysis, prior myocardial infarction odds ratio (OR): 0.71 (95% confidence interval [CI]: 0.59–0.87, p = 0.001), chronic lung disease OR: 0.64 (95% CI: 0.47–0.88, p = 0.006), and increasing procedure time OR: 0.93 (95% CI: 0.91–0.95, p < 0.001, per 10-min increase) were associated with overnight observation, while radial-only access OR: 2.45 (95% CI: 2.03–2.96, p < 0.001) had the strongest association with SDD. In the SDD, 2 (0.4%) of 514 patients were readmitted, due to retroperitoneal bleeding (n = 1) and ischemic stroke (n = 1). Conclusion: The overall frequency of SDD after CTO PCI was 13% and has been increasing over time. SDD is feasible in select patients following CTO PCI, and radial-only access had the strongest association with SDD.
AB - Background: Same day discharge (SDD) following chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods: We evaluated the clinical, angiographic, and procedural characteristics of patients discharged the same day versus those kept for overnight observation in the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention (PROGRESS-CTO, NCT02061436). Results: Of the 7181 patients who underwent CTO PCI, 943 (13%) had SDD. The SDD rate increased from 3% in 2015 to 21% in 2022. Patients with SDD were less likely to have a history of heart failure (21% vs. 26%, p = 0.005), chronic lung disease (10% vs. 15%, p = 0.001), or anemia (12% vs. 19%, p < 0.001). Technical success (87% vs. 88%, p = 0.289) was similar, but in-hospital major adverse cardiovascular events (0.0% vs. 0.4%, p = 0.041) were lower in SDD. In multivariable logistic regression analysis, prior myocardial infarction odds ratio (OR): 0.71 (95% confidence interval [CI]: 0.59–0.87, p = 0.001), chronic lung disease OR: 0.64 (95% CI: 0.47–0.88, p = 0.006), and increasing procedure time OR: 0.93 (95% CI: 0.91–0.95, p < 0.001, per 10-min increase) were associated with overnight observation, while radial-only access OR: 2.45 (95% CI: 2.03–2.96, p < 0.001) had the strongest association with SDD. In the SDD, 2 (0.4%) of 514 patients were readmitted, due to retroperitoneal bleeding (n = 1) and ischemic stroke (n = 1). Conclusion: The overall frequency of SDD after CTO PCI was 13% and has been increasing over time. SDD is feasible in select patients following CTO PCI, and radial-only access had the strongest association with SDD.
KW - chronic total occlusion
KW - overnight observation
KW - percutaneous coronary intervention
KW - same day discharge
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U2 - 10.1002/ccd.30644
DO - 10.1002/ccd.30644
M3 - Article
C2 - 36960766
AN - SCOPUS:85150917509
SN - 1522-1946
VL - 101
SP - 1028
EP - 1035
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -