Middle-of-the-night PCI does not affect subsequent day PCI success and complication rates by the same operator.

OBJECTIVE: To determine the impact of percutaneous coronary interventions (PCI) performed during late-night hours on next day PCI performance by the same interventional cardiologist.

BACKGROUND: There is little data regarding the effects of sleep deprivation on interventional cardiologists performing PCIs.

METHODS: All primary PCIs from January 1, 2005 to December 31, 2009 between 11 PM and 7 AM were identified. All PCIs performed during the subsequent work day by the same interventionists were included in the sleep-deprived group. All other PCIs were included in the non-sleep-deprived group. Data were entered prospectively into the American College of Cardiology National Cardiovascular Data Registry (NCDR). The two groups were compared with respect to efficacy and safety endpoints.

RESULTS: During the 5-year period, 3,944 PCIs were performed by four operators, including 3,644 non-sleep-deprived cases and 167 sleep-deprived cases. The two groups were similar with respect to demographics, comorbidities, and procedural characteristics. There were more intraprocedural deaths in the sleep-deprived group (1.2% vs. 0.2%, P = 0.04); however, the adjusted odds ratio (OR) was nonsignificant (OR = 6.83, 95% confidence interval [CI] = 0.66-39.63, P = 0.11). Excessive bleeding at the arterial access site in the non-sleep-deprived group was more frequent (2.7% vs. 0%, P = 0.02). There were no differences in the combined safety or efficacy endpoints between the two groups.

CONCLUSION: In this single-center study, we found no evidence that middle-of-the night procedures adversely affect safety or efficacy of procedures done the next day by the same operator.