Safety and clinical-cost effectiveness of percutaneous coronary interventions with overnight hospitalization

Cover Page


New methods and treatment plans for patients with chronic coronary artery disease after endovascular interventions are currently introduced into clinical practice. It allows reducing hospital stay down to 24 hour, with discharge the next morning. This approach is called «overnight stay». Using a similar strategy increases the availability of various types of endovascular interventions, shorter «waiting lists», and cut the cost of treatment due to a reduced hospital stay.

Full Text

Restricted Access

About the authors

A. B. Basinkevich

National Medical Research Center of Cardiology

Author for correspondence.
ORCID iD: 0000-0003-0720-0227

Russian Federation, Moscow

к.м.н., зам. глав. врача по амбулаторной работе, зав. консультативно-диагностическим отд-нием

Yu. G. Matchin

National Medical Research Center of Cardiology

ORCID iD: 0000-0002-0200-852X

Russian Federation, Moscow

д.м.н., рук. 2-го отд-ния рентгенэндоваскулярных методов диагностики и лечения

F. T. Ageev

National Medical Research Center of Cardiology

ORCID iD: 0000-0003-4369-1393

Russian Federation, Moscow

д.м.н., проф., рук. отд. амбулаторных лечебно-диагностических технологий


  1. Maron DJ. Nonlipid primary and secondary prevention strategies for coronary heart disease. Clin Cardiol. 1996;19:419-23. doi: 10.1002/clc.4960190517
  2. Гиляревский С.Р., Орлов В.А. Использование анализа эффективности лечения для принятия клинического решения в кардиологии. Кардиология. 1997;9:70-80 [Gilyarevsky SR, Orlov VA. The use of analysis of treatment effectiveness for clinical decision-making in cardiology. Cardiology. 1997;9:70-80 (In Russ.)].
  3. Шаповалова М.А., Корецкая Л.Р. Организация стационарной медицинской помощи в неврологической практике как медико-экономическая проблема. Кубанский научный медицинский вестник. 2011;2(125):183-6 [Shapovalova MA, Koretskaya LR. Organization of inpatient medical care in neurological practice as a medical and economic problem. Kuban scientific medical Bulletin. 2011;2(125):183-6 (In Russ.)].
  4. Moussa ID. Ambulatory outpatient percutaneous coronary intervention. Cardiac Interventions Today. 2015 July/August; p. 32-4.
  5. Amin AP, Crimmins-Reda P, Miller S, et al. Novel patient-centered approach to facilitate same-day discharge in patients undergoing elective percutaneous coronary intervention. J Am Heart Assoc. 2018;7: e 005733. doi: 10.1161/JAHA.117.005733
  6. Koch KT, Piek JJ, de Winter RJ, et al. Short term (4 hours) observation after elective coronary angioplasty. Am J Cardiol. 1997;80:1084-6. doi: 10.1016/S000-29149(97)00786-8
  7. Ormiston JA, Shaw B, Panther MJ, et al. Percutaneous coronary intervention with bivalirudin anticoagulation, immediate sheath removal, and early ambulation: a feasibility study with implications for day-stay procedures. Catheter Cardiovasc Interv. 2002;55:289-93. doi: 10.1002/ccd.10125
  8. Banning AP, Ormerod OJM, Channon K, et al. Same day discharge following elective percutaneous coronary intervention in patients with stable angina. Heart. 2003;89:665. doi: 10.1136/heart.89.6.665
  9. Chambers CE, Dehmer GJ, Cox DA, et al. Society for Cardiovascular Angiography and Interventions. Defining the length of stay following percutaneous coronary intervention: An expert consensus document from the Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2009;73:847-58. doi: 10.1002/ccd.22100
  10. Slagboom T, Kiemeneij F, Laarman JG, et al. Actual results of the OUTCLAS pilot study. Catheter Cardiovasc Intervent. 2001;53:204-8. doi: 10.1002/ccd.1149
  11. Heyde GS, Koch KT, De Winter RJ, et al. Randomized trial comparing same-day discharge with overnight hospital stay after percutaneous coronary intervention. Results of the elective PCI in outpatient study (EPOS). Circulation. 2007;115(17):2299-306. doi: 10.1161/CIRCULATIONAHA.105.591495
  12. Fajadet J, Morice MC, Bode C, et al. Maintenance of long-term clinical benefit with sirolimus – eluting coronary stents: three-year results of the RAVEL trial. Circulation. 2005;111(8):1040-4. doi: 10.1016/j.accreview.2005.06.042
  13. Rao SV, Kaithenbach LA, Weintraub WS, et al. Prevalence and outcomes of same-day discharge after elective percutaneous coronary intervention among older patients. JAMA. 2011;306:1461-7. doi: 10.1001/jama.2011.1409
  14. Abdelaal E, Rao SV, Gilchrist IC, et al. Same-day discharge compared with overnight hospitalization after uncomplicated percutaneous coronary intervention: A systematic review and meta-analysis. JACC Cardiovasc Interv. 2013;6:99-112. doi: 10.1001/jama.2011.1409
  15. Seto AH, Shroff A, Abu-Fadel M, et al. Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions. Catheter Cardiovasc Interv. 2018;92:717-31. doi: 10.1002/ccd.27637
  16. Rao SV, McCoy LA, Spertus JA, et al. An updated bleeding model to predict the risk of post procedure bleeding among patients undergoing percutaneous coronary intervention: A report using an expanded bleeding definition from the National Cardiovascular Data Registry CathPCI Registry. JACC Cardiovasc Interv. 2013;6:897-904. doi: 10.1016/j.jcin.2013.04.016
  17. Ziakas AA, Klinke BP, Mildenberger CR. Safety of same-day discharge after radial percutaneous coronary intervention: a retrospective study. Am Heart J. 2003;146:699-704. doi: 10.1016/S0002-8703(03)00258-8
  18. Bertrand OF, Rodes-Cabau J, Larose E, et al. One-year clinical outcome after abciximab bolus-only compared with abciximab bolus and 12-hour infusion in the Randomized EArly Discharge after Transradial Stenting of CoronarY Arteries (EASY) Study. Am Heart J. 2008;156:135-40. doi: 10.1016/j.ahj.2008.02.006
  19. Jabara R, Gadesam R, Pendyala L, et al. Ambulatory discharge after transradial coronary intervention: Preliminary US single-center experience (Same-day TransRadial Intervention and Discharge Evaluation, the STRIDE Study). Am Heart J. 2008;156:1141-6. doi: 10.1016/j.ahj.2008.07.018
  20. Koch KT, Piek JJ, Prins MH, et al. Triage of patients for short-term observation after elective coronary angioplasty. Heart. 2000;83:557-63. doi: 10.1136/heart.83.5.557
  21. Small A, Klinke P, Della Siega A, et al. Day procedure intervention is safe and complication free in higher risk patients undergoing transradial angioplasty and stenting. The DISCHARGE study. Catheter Cardiovasc Interv. 2007;70:907-12. doi: 10.1002/ccd.21277
  22. Brennan JM, Curtis JP, Dai D, et al. Enhanced mortality risk prediction with a focus on high-risk percutaneous coronary intervention: Results from 1,208,137 procedures in the NCDR (National Cardiovascular Data Registry). J Am Coll Cardiol Interv. 2013;6:790-9. doi: 10.1016/j.jcin.2013.03.020
  23. Tsai TT, Patel UD, Chang TI, et al. Validated contemporary risk model of acute kidney injury in patients undergoing percutaneous coronary interventions: Insights from the national cardiovascular data registry Cath-PCI registry. J Am Heart Assoc. 2014;3:e001380. doi: 10.1161/JAHA.114.001380
  24. Brayton KM, Patel VG, Stave C, et al. Same-day discharge after percutaneous coronary intervention: a meta-analysis. J Am Coll Cardiol. 2013;62(4):275-85. doi: 10.1016/S0735-1097(13)61132-8
  25. Bundhun PK, Soogund MZS, Huang WQ. Same day discharge versus overnight stay in the hospital following percutaneous coronary intervention in patients with stable coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. PLoS Plos One. 2017 January 9; p. 1-13. doi: 10.1371/journal.pone.0169807
  26. Din JN, Snow TM, Rao S, et al. Variation in practice and concordance with guideline criteria for length of stay after elective percutaneous coronary intervention. Catheter Cardiovasc Interv. 2017; 90(5):715-22. doi: 10.1002/ccd.26992
  27. Córdoba-Soriano JG, Rivera-Juarez A, Gutierrez-Diez A. The feasibility and safety of ambulatory percutaneous coronary interventions in complex lesions. Cardiovasc Revasc Med Rev Esp Cardiol (Engl Ed). 2017 Jul 27;70(7):535-42. doi: 10.1016/j.carrev.2018.12.001
  28. Helio G, Pozetti AVG, et al. Clinical outcomes of patients undergoing elective percutaneous coronary intervention with same-day discharge. Rev Bras Cardiol Invasiva. 2012;20(4):398-402. doi: 10.1016/S2214-1235(15)30085-5
  29. Ferrante G, Rao SV, Jüni P, et al. Radial versus femoral access for coronary interventions across the entire Spectrum of patients with coronary artery disease: A Meta-Analysis of Randomized Trials. JACC Cardiovasc Interv. 2016;9:1419-34. doi: 10.1016/j.jcin.2016.04.014
  30. Koifman E, Gaglia MA, Escarcega RO, et al. Comparison of transradial and transfemoral access in patients undergoing percutaneous coronary intervention for complex coronary lesions. Catheter Cardiovasc Interv. 2017;89:640-6. doi: 10.1002/ccd.26669
  31. Egred M. Feasibility and safety of 7-Fr radial approach for complex PCI. J Interv Cardiol. 2011;24:383-8. doi: 10.1111/j.1540-8183.2011.00658.x
  32. Amin AP, Patterson M, House JA, et al. Costs associated with access site and same-day discharge among Medicare beneficiaries undergoing percutaneous coronary intervention: An evaluation of the current percutaneous coronary intervention care pathways in the United States. JACC Cardiovasc Interv. 2017;10:342-51. doi: 10.1016/j. jcin.2016.11.049
  33. Sarno G, Lagerqvist B, Nilsson J, et al. Lower risk of stent thrombosis andrestenosis with unrestricted use of ‘new generation’ drug-eluting stents: A report from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Eur Heart J. 2012;33:606-13. doi: 10.1093/eurheartj/ehr479
  34. Navarese EP, Schulze V, Andreotti F, et al. Comprehensive meta-analysis of safety and efficacy of bivalirudin versus heparin with or without routine glycoprotein IIb/IIIa inhibitors in patients with acute coronary syndrome. JACC Cardiovasc Interv. 2015;8:201-13. doi: 10.1016/ j.jcin.2014.10.003
  35. Secemsky EA, Kirtane A, Bangalore S, et al. Practice patterns andin-hospital outcomes associated with bivalirudin use among patients with non-ST-segment-elevation myocardial infarction undergoing percutaneous coronary intervention in the United States. Circ Cardiovasc Qual Outcomes. 2017;10:e003741. doi: 10.1161/CIRCOUTCOMES. 117.003741
  36. Kwok CS, Rao SV, Potts JE, et al. Burden of 30 day readmissions after percutaneous coronary intervention in 833344 patients in the United States: predictors, causes and cost. Insights from the nationwide readmission database. JACC Cardiovasc Interv. 2018;11(7):665-749. doi: 10.1016/j.jcin.2018.01.248
  37. Kim M, Muntner P, Sharma S, et al. Assessing patient-reported outcomes andpreferences for same-day discharge after percutaneous coronary intervention: Results from a pilot randomized, controlled trial. Circ: Cardiovasc Qual Outcomes. 2013;6:186-92. doi: 10.1161/ CIRCOUTCOMES.111.000069
  38. Басинкевич А.Б., Матчин Ю.Г., Бубнов Д.С. и др. Клинико-экономическая эффективность проведения эндоваскулярного лечения коронарных артерий у больных со стабильной ишемической болезнью сердца при госпитализации на одну ночь. Кардиология. 2018;58(S3):36-45 [Basinkevich AB, Matchin YuG, Bubnov DS, et al. Clinical and cost effectiveness of percutaneous coronary intervention for patients with chronic coronary artery disease during overnight hospitalization. Kardiologiia. 2018;58(S3):36-45 (In Russ.)]. doi: 10.18087/cardio.2450
  39. Kiermeneij F, Laarman GL, et al. Outpatient coronary angioplasty: feasible and safe. Catheter Cardiovasc Interv. 2005;64:421-7. doi: 10.1002/ccd.20313
  40. Glaser R, Gertz Z, Matthai WH. Patient satisfaction is comparable to early discharge versus overnight observation after elective percutaneous coronary intervention. J Invasive Cardiol. 2009;21:464-7.
  41. Muthusamy P, Busman DK, Davis AT. Assesement of clinical outcomes related to early discharge after elective percutaneous coronary intervention. Catheter Cardiovasc Interv. 2013;81:6-13. doi: 10.1002/ccd.24537
  42. Mann T, Cubbedu G, Bowen J, et al. Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites. J Am Coll Cardiol. 1998;32:572-6. doi: 10.1016/S0735-1097(98)00288-5
  43. Mann T, Cowper PA, Peterson ED, et al. Transradial coronary stenting: comparison with femoral access closed with an arterial suture device. Catheter Cardiovasc Interv. 2000;49:150-6. doi: 10.1002/(SICI)1522-726X(200002)49:2<150::AID-CCD7>3.0.CO;2-F
  44. Kahn KL, Monica S. The efficacy of ambulatory cardiac catheterization in the hospital and free-standing setting. Am Heart J. 1986;111:152-67. doi: 10.1016/0002-8703(86)90567-3
  45. Cooper CJ, El-Shiekh RA, Cohen DJ, et al. Effect of transradial access on quality of life and cost of cardiac catheterization: a randomized comparison. Am Heart J. 1999;138:430-6. doi: 10.1016/S0002-8703(99)70143-2
  46. Rinfret S, Kennedy WA, Lachaine J, et al. Economic impact of same-day home discharge after uncomplicated transradial percutaneous coronary intervention and bolus-only abciximab regimen. JACC Cardiovasc Interv. 2010;3:1011-9. doi: 10.1016/j.jcin.2010.07.011
  47. Yost GW, Puher SL, Graham J, et al. Readmission in the 30 days after percutaneous coronary intervention. JACC Cardiovasc Interv. 2013;6:237-44. doi: 10.1016/j.jcin.2012.10.015
  48. Heuser RR. Make PCI great again: come on USA, catch up with the rest of the world. Catheter Cardiovasc Interv. 2017;90:723. doi: 10.1002/ccd.27356
  49. Valgimigli M, Gagnor A, Paolo C, et al. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: A randomized multicenter trial. Lancet. 2015;385:2465-76. doi: 10.1016/S0140-6736(15)60292-6
  50. Heuser RR. ACS treatment continues to improve: But price matters. Catheter Cardiovasc Interv. 2016;88:544-5. doi: 10.1002/ccd.26790
  51. Andersen JG, Grepperud S, Klow NE, et al. Effects on length of stay and costs with same-day retransfer to the referring hospitals for patients with acute coronary syndrome after angiography and/or percutaneous coronary intervention. Eur Heart J Acute Cardiovasc Care. 2016;5(4):375-80. doi: 10.1177/2048872615593386
  52. Popescu AM, Weintraub WS. Outpatient percutaneous coronary interventions hospital and health system costs saving while maintaining patient safety. JACC Cardiovasc Interv. 2010;3(10):1020-1. doi: 10.1016/j.jcin.2010.09.001
  53. Аронов Д.М. Проблема приверженности пребывания в стационаре больных острым инфарктом миокарда. Кардиология. 2010;4 [Aronov DM. The problem of adherence to hospital stay of patients with acute myocardial infarction. Cardiology. 2010;4 (In Russ.)].



Abstract - 56

PDF (Russian) - 16





  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:


© 2018 "Consilium Medicum" Publishing house

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies