Abstract
We suppose that few patients successfully treated with percutaneous coronary intervention (PCI) after acute myocardial ischemia (AMI) may drop out from a critical path treatment. We analyzed variances of our 2-week critical path for these patients. We studied consecutive 28 patients successfully treated with PCI after AMI, who were treated according to our 2-week critical path. We divided the patients into 2 groups; group A (n= 18) was the patients who were discharged within 2 weeks, group B (n=10) was the patients who were hospitalized over 2 weeks. We compared clinical and coronary characteristics and serum peak CPK level of the groups. Then, we analyzed variances of group B. Serum peak CPK level was significantly higher (group A: B=1058: 2620IU/ml, p<0.001) and the ratio of residual coronary stenosis and late complication were higher in group B (p<0.05). However, the main reason why hospitalization exceeded 2 weeks was assessing the coronary risk factors and educating the patients. Though the patients who hospitalized exceed the period of 2-week critical path had large infarction size, complicated coronary lesion and many late complications, these were not the main reasons of variances but needed more intensive assessments and education. We propose that the patients with small infarction size can safely treat for less than 2 weeks.
