Safety and Cost Implications of General Ward versus Coronary Care Unit Admission After PCI for Stable STEMI: A Propensity-Matched Analysis.

Background: Routine coronary care unit (CCU) admission after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) was affected during the COVID-19 pandemic. Infection control requirements require clinical assessment-based triaging to identify low-risk patients suitable for general ward admission. This study evaluated whether triaging clinically stable patients with STEMI (P-STEMI) to general wards is safe and cost-effective compared with CCU admission. Methods: This single-centre retrospective study included 486 P-STEMI who underwent PCI between January 2020 and December 2022; 82 were triaged to general wards and 404 to the CCU. A triage protocol based on COVID-19 testing status and clinical stability was implemented. Covariates were preselected using a directed acyclic graph (DAG) and balanced between groups via 1:1 propensity score matching. The primary outcome was total hospitalisation costs; secondary outcomes included in-hospital major adverse cardiovascular events (MACE) and length of stay. Results: In the original cohort, the general ward group had significantly lower costs (median $3515.59 vs $4057.86, Conclusion: For clinically stable P-STEMI post-PCI, triage to general wards was associated with significantly lower hospitalisation costs, and no statistically significant difference in MACE was observed.