Dr Olivier Bertrand (Laval Hospital, Quebec City, QC) told the audience that prior studies have demonstrated that transradial PCI is associated with extremely low rates of vascular complications and that outpatient PCI is feasible and safe. EASY was designed as a single-center, randomized noninferiority trial of patients undergoing transradial PCI.

A total of 1348 patients entered the study. Of these, 343 had predefined complications and received 12-hour infusion and hospitalization, as required. The study compared 501 patients who underwent uncomplicated transradial PCI, received abciximab, and were discharged the same-day vs 504 patients who received the single bolus plus 12-hour infusion and overnight stay.

The primary end point was a composite of death, MI, urgent revascularization, repeat hospitalization, severe thrombocytopenia, access-site complications, and major bleeding at 30 days following stent implantation. There was no difference in this end point between the two groups. There were no deaths, and numbers for bleeding were extremely low.

In summarizing the team's findings, Bertrand said: "ReoPro as a single bolus is clinically noninferior to the standard bolus and 12-hour infusion after uncomplicated stenting. The combination of transradial PCI and a single bolus of ReoPro is extremely safe and facilitates outpatient PCI in a wide spectrum of patients. The use of simple criteria identifying high-risk patients permits a change of PCI practice to same-day home discharge, therefore offering significant advantages in terms of bed occupancy and costs."

The trial's six-month results will be presented at the upcoming AHA meeting.

What Dr Bertrand appears to have done is basically given us one recipe for selection and management of same-day discharge [PCI patients].

Discussant Dr Madhu K Natarajan (McMaster University, Hamilton, ON) congratulated the investigators for a very nice trial. He noted: "Over the past decade there have been significant advances in PCI that have reduced the length of stay significantly, so that the majority of patients are already going home the very next day. . . . What Dr Bertrand appears to have done is basically given us one recipe for selection and management of same-day discharge [of PCI patients] and also shown that 12-hour infusion is maybe not necessary. . . . I think this practice will eventually be taken up, but there will be regional differences, partly because of different practice patterns."