title: Feasibility and safety of an early discharge strategy after low-risk acute myocardial infarction treated with primary percutaneous coronary intervention: the EDAMI pilot trial.
abstract: OBJECTIVE
  This pilot trial evaluated the feasibility and safety of an early discharge strategy (EDS: ≤72 h, followed by outpatient lifestyle interventions), in comparison with a conventional discharge strategy (CDS) for low-risk (Zwolle risk score ≤3) ST-elevation myocardial infarction (STEMI) patients treated with primary angioplasty.
  
  
  METHODS
  One hundred patients were randomized to an EDS (n = 54) or a CDS (n = 46). The primary end point was the feasibility of the EDS: (1) ≥70% of EDS patients discharged ≤72 h, (2) ≥70% visited by a nurse ≤7 days after discharge, (3) ≥70% with ≥3 visits by the nurse and (4) ≥70% visited by a cardiologist ≤3 months.
  
  
  RESULTS
  The mean age was 59.2 ± 12.2 years and ejection fraction 54.0 ± 7.1%. Eighty-six percent were male (12% diabetics). Vascular access was radial in 91%. Ischemic time was ≤4 h in 75%. Length of stay was shorter in EDS as compared with CDS (70.1 ± 8.1 vs. 111.8 ± 28.3 h, p < 0.001). EDS feasibility was: (1) 72.2%; (2) 81.5%; (3) 76.9%; (4) 72.2%. There were no adverse events or differences in intervention goals and quality of life between groups.
  
  
  CONCLUSIONS
  An EDS in low-risk STEMI patients is feasible and seems to be safe. A shorter hospital stay could benefit patients and health care systems.
authors.affiliation: Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Azzalini
authors.forename: Eduard
authors.initials: E
authors.lastname: Solé
authors.forename: Jordi
authors.initials: J
authors.lastname: Sans
authors.forename: Montserrat
authors.initials: M
authors.lastname: Vila
authors.forename: Albert
authors.initials: A
authors.lastname: Durán
authors.forename: Dolores
authors.initials: D
authors.lastname: Gil-Alonso
authors.forename: Miquel
authors.initials: M
authors.lastname: Santaló
authors.forename: Xavier
authors.initials: X
authors.lastname: Garcia-Moll
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sionis
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D010351:Patient Discharge; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D010865:Pilot Projects; D011788:Quality of Life; D012307:Risk Factors; D013318:Stroke Volume; D013997:Time Factors; D014463:Ultrasonography