Timing and Correlates of Very Early Major Adverse Clinical Events
Timing and Correlates of Very Early Major Adverse Clinical Events
We attempted to determine the incidence, timing and correlates of very early (< 24 hours) major adverse clinical events in patients undergoing contemporary percutaneous coronary intervention (PCI). Early discharge following PCI may offer significant advantages to patient and practitioner, but the timing of, and risk factors for, very early (< 24 hours) major adverse clinical events following PCI are not well characterized. A retrospective analysis of the CREDO trial was performed. A total of 1,815 patients underwent a PCI procedure and 139 patients (7.7%) experienced a major adverse clinical event (death, myocardial infarction or urgent target vessel revascularization) within the first 28 days. The majority of these events (111 patients) occurred within the first 24 hours, with the greatest risk of an event within the first 6 hrs. Multivariable predictors of very early events were age, AHA lesion grade, history of peripheral vascular disease, preprocedural TIMI flow grade and no. of vessels with stenosis > 50%. These data show a very low and constant risk of adverse events 6 hours following PCI.
The timing of, and risk factors for, very early (< 24 hours) major adverse clinical events (death, myocardial infarction [MI], urgent target vessel revascularization [uTVR], and major bleeding) following percutaneous coronary intervention (PCI) in the contemporary era of routine coronary stenting and aggressive adjunctive periprocedural antiplatelet therapy are not well characterized. Our understanding of this temporal relationship and the correlates of very early (24 hours) and early (28 days) adverse clinical outcomes is important as a basis for decisions regarding aggressiveness of in-hospital care and the duration of hospitalization, including same-day PCI in selected patient populations. Early discharge following PCI offers a number of advantages for the patient and for those responsible for provision of cardiac services.
We sought to determine the incidence and precise timing of major adverse clinical events in all patients undergoing PCI in the Clopidogrel for the Reduction of Events During Observation (CREDO) trial, to identify the clinical, angiographic and procedural correlates of very early major adverse clinical events in this cohort, and to compare and contrast these variables with correlates of 28-day outcomes.
We attempted to determine the incidence, timing and correlates of very early (< 24 hours) major adverse clinical events in patients undergoing contemporary percutaneous coronary intervention (PCI). Early discharge following PCI may offer significant advantages to patient and practitioner, but the timing of, and risk factors for, very early (< 24 hours) major adverse clinical events following PCI are not well characterized. A retrospective analysis of the CREDO trial was performed. A total of 1,815 patients underwent a PCI procedure and 139 patients (7.7%) experienced a major adverse clinical event (death, myocardial infarction or urgent target vessel revascularization) within the first 28 days. The majority of these events (111 patients) occurred within the first 24 hours, with the greatest risk of an event within the first 6 hrs. Multivariable predictors of very early events were age, AHA lesion grade, history of peripheral vascular disease, preprocedural TIMI flow grade and no. of vessels with stenosis > 50%. These data show a very low and constant risk of adverse events 6 hours following PCI.
The timing of, and risk factors for, very early (< 24 hours) major adverse clinical events (death, myocardial infarction [MI], urgent target vessel revascularization [uTVR], and major bleeding) following percutaneous coronary intervention (PCI) in the contemporary era of routine coronary stenting and aggressive adjunctive periprocedural antiplatelet therapy are not well characterized. Our understanding of this temporal relationship and the correlates of very early (24 hours) and early (28 days) adverse clinical outcomes is important as a basis for decisions regarding aggressiveness of in-hospital care and the duration of hospitalization, including same-day PCI in selected patient populations. Early discharge following PCI offers a number of advantages for the patient and for those responsible for provision of cardiac services.
We sought to determine the incidence and precise timing of major adverse clinical events in all patients undergoing PCI in the Clopidogrel for the Reduction of Events During Observation (CREDO) trial, to identify the clinical, angiographic and procedural correlates of very early major adverse clinical events in this cohort, and to compare and contrast these variables with correlates of 28-day outcomes.
