Safety and feasibility of returning patients early to their originating centers after transfer for primary percutaneous coronary intervention
Rodrigo Estévez-Loureiro, Ramón Calviño-Santos, José Manuel Vázquez, Eduardo Barge-Caballero, Jorge Salgado-Fernández, Miriam Piñeiro, Miguel Freire-Tellado, Jacobo Varela-Portas, Luisa Martínez, Sandra Gómez, José Angel Rodríguez, Nicolás Vázquez, Alfonso Castro-Beiras, Rodrigo Estévez-Loureiro, Ramón Calviño-Santos, José Manuel Vázquez, Eduardo Barge-Caballero, Jorge Salgado-Fernández, Miriam Piñeiro, Miguel Freire-Tellado, Jacobo Varela-Portas, Luisa Martínez, Sandra Gómez, José Angel Rodríguez, Nicolás Vázquez, Alfonso Castro-Beiras
Abstract
Introduction and objectives: At present, little information is available on returning patients with ST-elevation myocardial infarction (STEMI) to their originating centers after transfer for primary percutaneous coronary intervention (PPCI). The objective of this study was to evaluate the safety and feasibility of the early return of these patients to their originating centers.
Methods: The cohort study involved 200 consecutive STEMI patients (age 62+/-13 years, 83% male) who were returned to their originating centers after PPCI. They were compared with a group of 297 patients with similar characteristics from our healthcare catchment area. The length of stay in the intervention hospital and major adverse cardiovascular events occurring within 30 days were recorded.
Results: The median length of stay in the intervention hospital was 8 hours. No adverse events occurred during transport in the group who returned to their originating centers. At 30-day follow-up, no significant difference was observed between patients who returned and the control group in either mortality (1.0% vs. 3.7%; P=.064), readmission (5.0% vs. 4.5%; P=.657), ischemic complications (2.5% vs. 2.0%; P=.721), re-catheterization (5.0% vs. 2.5%; P=.112), stroke (1% vs. 1%; P=.936) or the composite end-point (11% vs. 9.2%; P=.540). Multivariate analysis showed that returning patients after PPCI was not associated with a significantly greater number of major adverse cardiovascular events (odds ratio=1.32; 95% confidence interval, 0.62-2.80).
Conclusions: The early return of patients with low-risk STEMI to their originating centers after PPCI was safe and feasible.
Source: PubMed