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January 18, 2012

Same-Day Discharge After Percutaneous Coronary Intervention—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Duke Clinical Research Institute, Durham, North Carolina (

JAMA. 2012;307(3):251-252. doi:10.1001/jama.2011.2017

In Reply: Dr Janus brings up several important issues regarding the practicalities of same-day discharge after PCI in the United States, such as fears over malpractice litigation and patient and family preferences. We agree that these are important issues to consider not only when attempting to explain patterns of care, but also when managing patients. Malpractice claims are often based on deviations from the standard of care, and we believe our study helps to define and defend the standard of care for low-risk patients undergoing PCI. While Janus laments the lack of real-world situations in studies such as ours, the CathPCI Registry is a contemporary registry of all patients undergoing PCI in clinical practice at the participating sites and thus does reflect real-world practice. What is missing from the data are patient preferences; however, we would argue that most patients who have social support would, if asked, prefer to recover at home rather than in the unfamiliar hospital setting.

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