Safety and feasibility of very early discharge after primary pci in low-riskSTEMI patients : a prospective study
A Ait Yahya, M Ztati, W Dahmane, M El HattaouiAbstract
Background
Very early discharge after successful primary percutaneous coronary intervention (PCI) has been increasingly considered for carefully selected low-risk patients with ST-segment elevation myocardial infarction (STEMI). However, prospective data from resource-limited settings remain limited.
Objective
To evaluate the safety and feasibility of very early discharge (≤48 hours) in low-risk STEMI patients treated with primary PCI.
Methods
We conducted a prospective, randomized, open-label, single-center study between June 2024 and June 2025. During this period, 544 consecutive patients were admitted with STEMI. Among them, 179 met predefined low-risk criteria based on preserved left ventricular ejection fraction, limited coronary artery disease burden, and successful radial-access PCI. These patients were randomly assigned to either very early discharge (≤48 hours) or routine discharge (>48 hours). The primary endpoint was the occurrence of major adverse cardiovascular events (MACE) at 3 months, defined as all-cause mortality, recurrent myocardial infarction, hospitalization for heart failure, or stent thrombosis.
Results
A total of 82 patients were allocated to the very early discharge group, with a median hospital stay of 25.8 hours, and 97 patients to the routine discharge group. At 3-month follow-up, the incidence of MACE was similar between the two groups, with with no statistically significant difference in MACE (2.4% vs 2.1%; p = 1.00).
Conclusion
In this prospective randomized study of carefully selected low-risk STEMI patients, very early discharge within 48 hours after primary PCI was not associated with an increased risk of adverse cardiovascular events at 3 months. These findings suggest that an individualized early discharge strategy may be safely implemented in selected patients.Consort study flow chartKaplan Meier curve