Same-day discharge after percutaneous coronary intervention in France: a nationwide analysis from the France PCI registry

Background

Same-day discharge after percutaneous coronary intervention (PCI) has been increasingly adopted worldwide; however, nationwide data from France remain scarce. A comprehensive evaluation is needed to describe current practices and assess safety in real-world settings.

Objectives

To describe the current use of same-day discharge PCI in France, compare clinical and procedural characteristics between ambulatory and overnight hospitalization strategies, and evaluate 30-day clinical outcomes.

Methods

We conducted a nationwide retrospective observational study using the France PCI registry including elective PCI procedures performed between 2022 and 2023 in stable patients. Acute coronary syndromes were excluded. Patients were classified according to discharge strategy: same-day discharge or overnight hospitalization. Clinical outcomes at 30 days were compared between groups.

Results

A total of 21,874 patients were included, of whom 6,089 (27.8%) underwent same-day discharge PCI and 15,785 (72.2%) overnight hospitalization. Ambulatory patients were slightly younger (68 vs 70.1 years) and had fewer comorbidities, including severe chronic kidney disease (0.6% vs 1.2%) and left ventricular dysfunction (LVEF <40%: 4.9% vs 7.8%). Radial access was more frequently used in the ambulatory group (95.1% vs 92%). Same-day discharge procedures involved less complex coronary disease, fewer treated vessels and stents, and were associated with shorter fluoroscopy time and lower radiation exposure.

At 30 days, major adverse cardiovascular events were rare and comparable between groups, with very low rates of stent thrombosis (0.1% vs 0.2%), myocardial infarction, stroke, and urgent revascularization. Major bleeding events (BARC ≥3) were infrequent and occurred less often in the ambulatory group (0.1% vs 0.3%).

Conclusions

In the France PCI registry, same-day discharge accounts for more than one quarter of elective PCI procedures. In carefully selected stable patients, ambulatory PCI appears safe, with 30-day outcomes comparable to overnight hospitalization. These findings support broader implementation of same-day discharge PCI in France, particularly with systematic radial access and appropriate patient selection.