Document Detail


Same-day transfer of patients with unstable angina and non-ST segment elevation myocardial infarction back to their referring hospital after angioplasty.
MedLine Citation:
PMID:  16639476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Recent evidence has shown the advantages of an early invasive strategy for patients with high-risk unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI). However, the number of beds available for postangioplasty monitoring limits the use of this approach at the Centre hospitalier universitaire de Sherbrooke (Fleurimont, Quebec). OBJECTIVES: To study the safety of a protocol allowing the same-day return of patients with UA or NSTEMI to their referring hospital after angioplasty at the Centre hospitalier universitaire de Sherbrooke. METHODS: From June 2001 to June 2003, of the 532 patients with UA and NSTEMI who underwent percutaneous coronary intervention with planned same-day transfer back to their referring hospital, 419 consecutive patients who were eligible to return the same day were prospectively followed for 24 h. RESULTS: Stents were used in 94.7% of patients and platelet glycoprotein IIb/IIIa receptor antagonists were used in 34.8% of patients. For 85% of patients, the femoral artery was used as the access route for percutaneous coronary intervention. The mean time that patients stayed in the hospital after angioplasty before returning to their referring centres was 4.4 h. No deaths, life-threatening arrhythmias or urgent revascularizations were reported during the 24 h postangioplasty follow-up period, but one patient had a major bleeding complication. During the study period, the mean angioplasty waiting time decreased from 5.7 days to 2.1 days. CONCLUSIONS: The protocol evaluated in the present article is safe. It frees more beds, thus reducing the waiting list and allowing patients with high-risk acute coronary syndromes without ST segment elevation from community hospitals to benefit from the advantages of an early invasive strategy.
Authors:
Doan Hoa Do; Karl Dalery; André Gervais; Richard Harvey; Serge Lepage; Andrée Maltais; Michel Nguyen
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  22     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-04-26     Completed Date:  2006-06-13     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  405-9     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Centre Hospitalier Universitaire de Sherbrooke, Fleurimont, Québec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina, Unstable / therapy*
Angioplasty, Transluminal, Percutaneous Coronary / standards*,  statistics & numerical data
Cardiology / standards
Clinical Protocols*
Female
Follow-Up Studies
Humans
Length of Stay / statistics & numerical data
Male
Middle Aged
Myocardial Infarction / therapy*
Outcome and Process Assessment (Health Care)
Patient Transfer / standards*,  statistics & numerical data
Prospective Studies
Quebec
Referral and Consultation / statistics & numerical data
Comments/Corrections

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