Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
Identification of Uncomplicated Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention
Are These Patients Suitable for Early Discharge?
Kunihiro KinjoHiroshi SatoYasuhiko SakataDaisaku NakataniHiroya MizunoMasahiko ShimizuMasami NishinoYasuhiko Matsu-uraYukihiro KoretsuneShinsuke NantoMasayoshi MishimaMasatsugu Horion Behalf of the Osaka Acute Coronary Insufficiency Study (OACIS) Group
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2005 Volume 69 Issue 10 Pages 1163-1169

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Abstract

Background The hospital stay after acute myocardial infarction (AMI) is still extremely long in Japan and does not correspond with disease severity. The purpose of the present study was to identify a subgroup of AMI patients suitable for early discharge. Methods and Results A total of 3,739 AMI patients treated with percutaneous coronary intervention (PCI) within 24 h after onset, who enrolled Osaka Acute Coronary Insufficiency Study between April 1998 and March 2004, were studied. Patients showing no complications within the first 7 days (n=1,786) were considered to be eligible for early discharge. In these patients, multivariate logistic regression analysis selected prior myocardial infarction, left anterior descending coronary artery disease and failed PCI as independent predictors of major complications from day 8 to discharge. Patients without any predictor had significant lower rates of major complications from day 8 to 6 months after discharge than those with 1 or more predictors. Furthermore, in the present study there were no deaths in patients without any predictors. Conclusion Patients who either do not have serious complications during the first 7 days or any predictor are at very low risk of major complications from day 8 to 6 months after discharge. These carefully selected patients may be suitable for early (day 8) hospital discharge after AMI. (Circ J 2005; 69: 1163 - 1169)

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© 2005 THE JAPANESE CIRCULATION SOCIETY
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