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经皮冠状动脉介入治疗后当日出院——奥地利心脏病学会介入心脏病学工作组(AGIK)的共识声明。

Same-day discharge after percutaneous coronary procedures-Consensus statement of the working group of interventional cardiology (AGIK) of the Austrian Society of Cardiology.

机构信息

Department of Internal Medicine II, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria.

Department of Cardiology, Public Hospital Klagenfurt am Woerthersee, Klagenfurt am Woerthersee, Austria.

出版信息

Wien Klin Wochenschr. 2024 May;136(Suppl 3):61-74. doi: 10.1007/s00508-024-02348-y. Epub 2024 May 14.

DOI:10.1007/s00508-024-02348-y
PMID:38743084
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11093795/
Abstract

INTRODUCTION

Percutaneous coronary intervention is a well-established revascularization strategy for patients with coronary artery disease. Recent technical advances such as radial access, third generation drug-eluting stents and highly effective antiplatelet therapy have substantially improved the safety profile of coronary procedures. Despite several practice guidelines and a clear patient preference of early hospital discharge, the percentage of coronary procedures performed in an outpatient setting in Austria remains low, mostly due to safety concerns.

METHODS

The aim of this consensus statement is to provide a practical framework for the safe and effective implementation of coronary outpatient clinics in Austria. Based on a structured literature review and an in-depth analysis of available practice guidelines a consensus statement was developed and peer-reviewed within the working group of interventional cardiology (AGIK) of the Austrian Society of Cardiology.

RESULTS

Based on the available literature same-day discharge coronary procedures show a favorable safety profile with no increase in the risk of major adverse events compared to an overnight stay. This document provides a detailed consensus in various clinical settings. The most important prerequisite for same-day discharge is, however, adequate selection of suitable patients and a structured peri-interventional and postinterventional management plan.

CONCLUSION

Based on the data analysis this consensus document provides detailed practice guidelines for the safe operation of daycare cathlab programs in Austria.

摘要

简介

经皮冠状动脉介入治疗是冠心病患者公认的血运重建策略。最近的技术进步,如桡动脉入路、第三代药物洗脱支架和高效抗血小板治疗,极大地提高了冠状动脉介入治疗的安全性。尽管有几项实践指南和明确的患者倾向于早期出院,但奥地利在门诊进行冠状动脉介入治疗的比例仍然很低,主要是出于安全考虑。

方法

本共识声明的目的是为奥地利安全有效地实施冠状动脉门诊提供一个实用的框架。基于系统的文献回顾和对现有实践指南的深入分析,在奥地利心脏病学会介入心脏病学工作组(AGIK)内部制定了一项共识声明,并进行了同行评议。

结果

基于现有文献,与过夜住院相比,当天出院的冠状动脉介入治疗具有良好的安全性,重大不良事件的风险没有增加。本文在各种临床环境下提供了详细的共识。然而,当天出院的最重要前提是,适当选择合适的患者,并制定结构化的围手术期和术后管理计划。

结论

基于数据分析,本共识文件为奥地利日间导管室计划的安全运行提供了详细的实践指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4947/11093795/8f6eb2a27a42/508_2024_2348_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4947/11093795/8f6eb2a27a42/508_2024_2348_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4947/11093795/8f6eb2a27a42/508_2024_2348_Fig1_HTML.jpg

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Safety of same-day discharge in patients with left main percutaneous intervention.左主干经皮介入治疗患者当日出院的安全性
Coron Artery Dis. 2022 Aug 1;33(5):415-418. doi: 10.1097/MCA.0000000000001121. Epub 2022 Apr 27.
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Trends in Use and Outcomes of Same-Day Discharge Following Elective Percutaneous Coronary Intervention.
择期经皮冠状动脉介入治疗后当日出院的使用趋势和结局。
JACC Cardiovasc Interv. 2021 Aug 9;14(15):1655-1666. doi: 10.1016/j.jcin.2021.05.043.
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Intracoronary optical coherence tomography: state of the art and future directions.冠状动脉光学相干断层成像术:现状与未来方向。
EuroIntervention. 2021 Jun 11;17(2):e105-e123. doi: 10.4244/EIJ-D-21-00089.
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2021 ACC Expert Consensus Decision Pathway on Same-Day Discharge After Percutaneous Coronary Intervention: A Report of the American College of Cardiology Solution Set Oversight Committee.2021年经皮冠状动脉介入治疗后当日出院的美国心脏病学会专家共识决策路径:美国心脏病学会解决方案集监督委员会报告
J Am Coll Cardiol. 2021 Feb 16;77(6):811-825. doi: 10.1016/j.jacc.2020.11.013. Epub 2021 Jan 7.
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Am J Cardiol. 2021 Mar 15;143:21-28. doi: 10.1016/j.amjcard.2020.12.039. Epub 2021 Jan 5.
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