What is the optimal length of stay in hospital for ST elevation myocardial infarction treated with primary percutaneous coronary intervention?

BACKGROUND The aim of this study was to evaluate the safety and practicality of very early (within 48 h) discharge with long-term follow-up results, and to define an optimal length of stay in hospital for patients with ST elevation myocardial infarction (STEMI) according to their demographic characteristics and risk assessment. METHODS A total of 267 patients with STEMI successfully treated with primary coronary intervention were retrospectively analyzed. Patients was divided into four groups according to length of hospitalization: 24 hours, 48 hours, 72 hours, and more than 72 hours. The groups were compared in terms of the patients' demographic and clinical characteristics, short- and long-term follow-up results, mortality, revascularization and major adverse cardiac events (MACE). RESULTS More than two thirds of the patients were discharged within 48 hours (68.9%). No difference was observed between groups in terms of one month and one year MACE and one year restenosis. However, one month restenosis was slightly higher in the fourth group. At the end of the first year, there had been only four deaths, and these were in the third and fourth groups. There were no deaths among patients discharged within 48 hours. Killip class, left ventricular ejection fraction, multi-vessel disease and diabetes were the major determinants of length of stay in hospital. CONCLUSIONS Very early discharge is safe and feasible and does not increase the mortality rate. Uncomplicated STEMI patients with single vessel disease could be discharged after 24 hours. Patients with multi-vessel disease classified in the low risk group could be discharged after 48 hours.