23 Feasibility of a Fast Track Pathway for High Risk ACS: Effects on Angiography Times, Length of Stay and Mortality

ObjectiveTo determine the feasibility of a fast track pathway for high risk Non ST elevation acute coronary syndrome (NSTEACS) patients and to determine outcomes when compared with a conventional pathway of treatment.MethodsThis was a retrospective analysis comparing high risk NSTEACS patients admitted via a fast track pathway, with age and sex matched controls admitted via the conventional pathway.ResultsOver a period of 26 months, 96 patients were admitted through the Fast Track NSTEACS group and 78 patients through the control group. There was shorter duration of hospital stay for the fast track group (mean hospital stay, 3.4; SD 3.63 days) compared to the control group (mean hospital stay, 5.6 days (SD: 4.07), p < 0.001). Time from admission to angiography was quicker in fast track group (median time in hours 5.2 (IQR 1.9–31.7) vs 59.6 (IQR 33.5–101.3); p < 0.001. There was no difference in 6-month mortality (Unadjusted survival probability %, vs 93.6%; p = 0.50) (Figure 1) or peak troponin levels (0.95 vs 1.19; p = 0.40).Abstract 23 Figure 1Kaplan-Meier survival curves showing no difference in mortality (in-hospital and medium term) between the two groupsConclusionAdmission of high-risk NSTEACS patients by fast track pathway resulted in shorter time from admission to angiography and shorter hospital stay, but had no significant effect on patients’ 6-month mortality risk or peak troponin release when compared to those admitted via existing pathways.