LAUSR

Introduction In 2016, 100,483 patients in the United Kingdom underwent PCI (1). PCI is a guideline recommended treatment for coronary artery disease (2). Contemporary techniques and pharmacotherapy strategies have improved the safety of PCI, thus reducing risk of major adverse cardiovascular events (MACE) and the requirement for overnight stay in elective cases. Published data have demonstrated that the majority of post-procedural complications occur within the initial 6 hours, and that patients can be safely discharged after a period of observation (3). Implementation of these recommendations into clinical practice has the potential to provide significant healthcare cost savings. Objectives This study aimed to evaluate the clinical outcomes of patients undergoing elective PCI at a tertiary cardiac centre, determine rates of elective SDD PCI, and identify potential areas for service improvement. Methods Elective PCI procedures over a 12-month period (October 2016 – September 2017) were electronically retrieved from our trust’s TOMCAT cardiovascular information system. Incidence of MACE at 30 days after PCI was recorded following review of procedure reports, discharge summaries and hospital re-admission data. NHS numbers were used as unique identifiers to ensure robust data collection. Our data was subsequently compared with the British Cardiovascular Intervention Society (BCIS) 2016 audit results. Results 306 patients underwent elective PCI during the study period. 1.3% incidence of MACE was recorded (death 0.32% [n=1]; MI 0.32% [n=1]; urgent revascularisation 0.65% [n=2]; stroke [n=0]; emergency CABG [n=0]). 55% (168/306) of elective PCI was performed as a SDD. 34 patients were admitted overnight, despite undergoing uncomplicated single-vessel PCI. Applying published criteria, SDD would have been appropriate in this group. Abstract 66 Table 1 Conclusion This study demonstrates that elective PCI at our centre is safe and results in low rates of MACE, with clinical outcomes comparable to national audit data. 55% of elective PCI at our centre is SDD, considerably higher than BCIS figures. Patients suitable for SDD were identified and will be the focus of future pathway and service improvement. References British Cardiovascular Intervention Society. BCIS Audit 2016. http://www.bcis.org.uk/wp-content/uploads/2018/03/BCIS-Audit-2016-data-ALL-excluding-TAVI-08-03-2018-for-web.pdf BCIS Audit (Accessed 27th February 2019). Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2019;40(2):87–165. Brayton KM, Patel VG, Stave C, de Lemos JA, Kumbhani DJ. Same-day discharge after percutaneous coronary intervention: a meta-analysis. J Am Coll Cardiol 2013;62(4):275–85. Conflict of Interest None