Safety and feasibility of returning patients immediately to their originating hospitals after primary percutaneous coronary intervention

• Main Author: Rahim Gul
• Format: Article
• Language: English
• Published: Saudi Heart Association 2018-10-01
• Series: Journal of the Saudi Heart Association
• Online Access: http://www.sciencedirect.com/science/article/pii/S1016731518301684

Introduction: Primary percutaneous coronary intervention (PCI) has become the preferred re-perfusion strategy for ST-elevation myocardial infarction (STEMI). However, bed shortages in most tertiary hospitals limit access to primary PCI for patients presenting to community hospitals who need to be transferred for the procedure. Strategies to expand the availability of this effective treatment are required. The objective of this study was to evaluate the safety and feasibility of the immediate return of these patients to their originating Hospitals after PPCI for STEMI. Methodology: The study involved 350 STEMI patients with mean age 51 years and 91.3% male who were transfer back to their parent Hospitals after PPCI. Major and minor adverse cardiovascular events occurring during retransfer back in the ambulance, during hospital stay in parent hospitals and during one month follow up post discharge from the parent hospital were recorded. Results: The median length of stay post PPCI in the intervention hospital was 45 min. No adverse events occurred during Ambulance Transport back to their parent hospitals. The median length of stay in Parent hospitals was 5 days. 3 patients were readmitted from the parent hospital one with AV block, second with re infarction found to have acute stent thrombosis and third with chest pain found to have patent stent. There was no stroke or major bleeding. One patient had hematoma to the right arm. One patient died who had re-infarction on second day post PPCI due to stent thrombosis. Analysis showed that returning patients after PPCI was not associated with an increased number of major or minor adverse cardiovascular events. Conclusion: The immediate return of low risk STEMI patients to their originating hospitals after PPCI is safe and feasible and is effective strategy to provide this prefer and effective re-perfusion therapy to vast majority of patients with STEMI.