Early discharge after acute myocardial infarction: who and when?

In recent decades, we have witnessed dramatic reductions in the mortality risk of acute myocardial infarction and, at the same time, concerted and fruitful efforts to reduce length of stay. In this issue, Senaratne et al. report the results of an expanded strategy of early discharge, which included most patients admitted to the Coronary/Intermediate Care Unit (CICU) of the Grey Nuns Hospital in Edmonton, Canada in 1995 and 1996 (1). Patients received usual medical care in the CICU, but instead of being transferred to a general medical unit when “stable,” eligible patients remained in the CICU for a program of early ambulation, education and direct discharge. Stable patients were allowed to walk in