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Purpose: Substantial heterogeneity in hospital length of stay exists among patients admitted with non-ST-segment elevation myocardial infarction. Furthermore, little is known about the factors that impact length of stay., Methods: We examined 39,107 non-ST-segment elevation myocardial infarction patients admitted to 351 Acute Coronary Treatment Intervention Outcomes Network Registry-Get With The Guidelines hospitals from January 1, 2007-March 31, 2009 who underwent cardiac catheterization and survived to discharge. Length of stay was categorized into 4 groups (≤2, 3-4, 5-7, and ≥8 days), where prolonged length of stay was defined as >4 days., Results: The overall median (25(th), 75(th)) length of stay was 3 (2, 5) days. Patients with a length of stay of >2 days were older with more comorbidities, but were less likely to receive evidence-based therapies or percutaneous coronary intervention. Among the factors associated with prolonged length of stay >4 days were delay to cardiac catheterization >48 hours, heart failure or shock on admission, female sex, insurance type, and admission to the hospital on a Friday afternoon or evening. Hospital characteristics such as academic versus nonacademic or urban versus rural setting, were not associated with prolonged length of stay., Conclusion: Patients with longer length of stay have more comorbidities and in-hospital complications, yet paradoxically, are less often treated with evidence-based medications and are less likely to receive percutaneous coronary intervention. Hospital admission on a Friday afternoon or evening and delays to catheterization appear to significantly impact length of stay. A better understanding of factors associated with length of stay in patients with non-ST-segment elevation myocardial infarction is needed to promote safe and early discharge in an era of increasingly restrictive health care resources., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Bleeding complications after percutaneous coronary interventions (PCI) are a significant clinical problem associated with worse patient outcomes, including mortality. A number of studies have demonstrated that the majority of bleeding complications in patients undergoing PCI are related to access-site bleeding. Employing the transradial artery approach to PCI markedly reduces these bleeding rates. The reductions in bleeding and transfusions from employing the transradial approach may be associated with improved survival in PCI patients. Despite these data, the prevalence of transradial PCI remains low and its adoption by operators has been slow to increase. Growing data to support the superior clinical outcomes with radial artery PCI, coupled with improved awareness of this data, may lead to increases in its adoption and improved clinical outcomes and mortality after PCI.