Study Of Costs Realized After Percutaneous Coronary intervenTion Employing Same Day Discharge (SOCRATES)

This is an interventional health services research trial for Coronary Artery Disease focused on measuring Coronary artery disease, Costs, Cost minimization, Percutaneous coronary intervention, Risk score, Same day discharge Read More

Inclusion Criteria:

• Consecutive patients who undergo elective or low-risk, (i.e., in the setting of unstable angina but not non-ST segment elevation myocardial infarction) urgent PCI.
• No sociodemographic factors that would preclude SDD (prohibitive factors include no family member/friend available to remain with patient until nurse phone call the following day, no working phone, no reliable transportation, home > 60 minutes from medical infrastructure, unable to obtain/pay for medications).
• PCI procedures performed between 08/04/14 and 08/03/16.
• Short term risk of in-hospital death, transfusion or contrast-induced nephropathy during the index hospitalization at or below 1% using Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) PCI registry risk prediction models.
• No in-lab complications (prolonged angina, acute closure, no reflow, significant or untreated dissection, vessel perforation, side branch occlusion, rescue glycoprotein IIb/IIIa inhibitor use, ventricular tachycardia or fibrillation requiring cardioversion/defibrillation, tamponade, pulmonary edema, stroke or transient ischemic attack, shock).
• Contrast Volume/Calculated Creatinine Clearance ratio < 3
• No recurrent chest pain, shortness of breath, hemodynamic instability, bleeding or vascular complications during 6 hours in recovery area post-PCI

Exclusion Criteria:

• Use of rotational atherectomy
• Use of a glycoprotein IIb/IIIa inhibitor infusion post-PCI