Current European and American guidelines recommend early discharge for patients with uncomplicated acute myocardial infarction (AMI). However, this concept has not been widely accepted, and experience with direct discharge from the coronary care unit is limited. We aimed to investigate safety and cost effectiveness of early discharge directly from coronary care unit following successful percutaneous coronary angioplasty (PTCA) in patients with uncomplicated AMI. We included consecutive thirty-one patients with uncomplicated AMI and successful PTCA admitted to coronary care unit of a university hospital. Uncomplicated course was defined as absence of reinfarction, ischemia, VF/VT, repeated PTCA, and heart failure within first 72 hours. Incidence of death, reinfarction, VF/VT, need for revascularisation, and hospitalisation due to heart failure at 1, 6, and 12 months was compared with 56 randomly selected AMI patients with successful PTCA but longer hospitalisation. Average hospital stay was 4 days in early and 6.7 days in control group (p<0.05). Control group had more extensive coronary disease (54% two or more vessels vs. 28% in early discharge, p<0,05). During follow up, none of the early discharged patients died, the only observed event was repeat PTCA due to angina pectoris. In the control group, mortality at 12 months was 3.5% (p<0.05). Cumulative 12 month event free survival was 96% in early discharge group and 87% in control group, but difference was not significant (p=0.15, Cox-Mantel test). Cost reduction of early discharge amounted to 1100 Euro per patient. In conclusions, our study confirmed that for a selected population of patients with AMI, successful PTCA, and uncomplicated clinical course during first 72 hours, discharge as early as three days following the admission is safe.
 The task force on the management of acute myocardial infarction of the European Society of Cardiology. Management of acute myocardial infarction in patients presenting with ST-segment elevation, Eur. Heart. J., 2002, 24, 28–66
 Sans S., Kesteloot H., Kromhout D. on behalf of the Task Force. The burden of cardiovascular diseases mortality in Europe. Task Force of the European Society of Cardiology on cardiovascular mortality and morbidity statistics in Europe, Eur. Heart. J., 1997, 18, 1231–1248
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