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Impact of routine 24 hour Coronary Care Unit stay in stable patients after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

The American Journal of Cardiology Apr 09, 2020

McIntyre WF, et al. - Researchers compared two groups of stable patients admitted to the Coronary Care Unit (CCU) after primary-percutaneous coronary intervention (PCI) for ST-Elevation Myocardial Infarction (STEMI)—those for whom a minimum 24-hour stay was enforced (≥ 24 h Standard Stay) and those with no minimum length-of-stay (Physician-guided Stay)—in terms of the rate of complications. Participants were 242 patients in total. A composite of in-hospital mortality, re-infarction/re-intervention, heart failure needing intravenous diuretics, cardiac arrest, central nervous system/peripheral embolization, bleeding requiring transfusion, arrhythmia causing start of a class I or III anti-arrhythmic drug, start of assisted ventilation, need for vasopressors or inotropes, or transfer to intensive care, was the primary endpoint. In the Physician-Guided Stay Group and in the Standard ≥24 hour Stay Group, the rate of the primary endpoint was estimated to be 8% and 16%, respectively. A low rate of complications was found in patients who were stable after primary PCI for STEMI. A mandatory ≥ 24 h stay in the CCU did not seem to be beneficial for stable STEMI patients.

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