Radial or femoral access in primary percutaneous coronary intervention (PCI): Does the choice matters?
Catheterization, Peripheral
/ methods
Coronary Angiography
Electrocardiography
Female
Femoral Artery
Follow-Up Studies
Hospital Mortality
/ trends
Humans
Male
Middle Aged
Pakistan
/ epidemiology
Percutaneous Coronary Intervention
/ methods
Propensity Score
Prospective Studies
Radial Artery
Risk Factors
ST Elevation Myocardial Infarction
/ diagnosis
Treatment Outcome
Mortality
Primary percutaneous coronary interventions
Propensity-matched
ST-Segment evaluation myocardial infarction
Trans-Radial
Journal
Indian heart journal
ISSN: 2213-3763
Titre abrégé: Indian Heart J
Pays: India
ID NLM: 0374675
Informations de publication
Date de publication:
Historique:
received:
12
12
2019
revised:
07
05
2020
accepted:
10
05
2020
entrez:
10
8
2020
pubmed:
10
8
2020
medline:
18
3
2021
Statut:
ppublish
Résumé
This study was conducted with the aim of providing a quantitative appraisal of clinical outcomes of trans-radial access for primary percutaneous coronary interventions (PCI) in patients with ST-segment evaluation myocardial infarction (STEMI). In this study, we compared two propensity-matched cohorts of patients who underwent primary PCI via trans-radial (TRA) and trans-femoral access (TFA) in a 1:1 ratio. The profile of two cohorts was matched for gender, age, and body mass index, diabetes, hypertension, family history, and smoking. The outcomes of primary PCI were compared for the two cohorts which included all-cause in-hospital mortality, heart failure, re-infarction, cardiogenic shock, bleeding, transfusion, cerebrovascular accident, and dialysis. This analysis was performed on a total of 2316 patients with 1158 patients each in the TRA and TFA group. We observed significantly lower rates of mortality, 0.8% (9) vs. 3.5% (41); p < 0.001 and bleeding, 0.5% (6) vs.1.6% (19); p = 0.009 with shorter hospital stay, 1.61 ± 1.39 vs. 1.98 ± 1.5 days, in trans-radial vs. trans-femoral. However, both fluoroscopic time and contrast volume were significantly higher in the TRA as compared to TFA group 15.57 ± 8.16 vs. 12.79 ± 7.82 min; p < 0.001 and 143.22 ± 45.33 vs. 133.78 ± 45.97; p < 0.001 respectively. Compared with TFA access, TRA for primary PCI is safe for patients with STEMI, it was found to be associated with a significant reduction in in-hospital mortality and bleeding complications.
Sections du résumé
BACKGROUND
BACKGROUND
This study was conducted with the aim of providing a quantitative appraisal of clinical outcomes of trans-radial access for primary percutaneous coronary interventions (PCI) in patients with ST-segment evaluation myocardial infarction (STEMI).
METHODS
METHODS
In this study, we compared two propensity-matched cohorts of patients who underwent primary PCI via trans-radial (TRA) and trans-femoral access (TFA) in a 1:1 ratio. The profile of two cohorts was matched for gender, age, and body mass index, diabetes, hypertension, family history, and smoking. The outcomes of primary PCI were compared for the two cohorts which included all-cause in-hospital mortality, heart failure, re-infarction, cardiogenic shock, bleeding, transfusion, cerebrovascular accident, and dialysis.
RESULTS
RESULTS
This analysis was performed on a total of 2316 patients with 1158 patients each in the TRA and TFA group. We observed significantly lower rates of mortality, 0.8% (9) vs. 3.5% (41); p < 0.001 and bleeding, 0.5% (6) vs.1.6% (19); p = 0.009 with shorter hospital stay, 1.61 ± 1.39 vs. 1.98 ± 1.5 days, in trans-radial vs. trans-femoral. However, both fluoroscopic time and contrast volume were significantly higher in the TRA as compared to TFA group 15.57 ± 8.16 vs. 12.79 ± 7.82 min; p < 0.001 and 143.22 ± 45.33 vs. 133.78 ± 45.97; p < 0.001 respectively.
CONCLUSIONS
CONCLUSIONS
Compared with TFA access, TRA for primary PCI is safe for patients with STEMI, it was found to be associated with a significant reduction in in-hospital mortality and bleeding complications.
Identifiants
pubmed: 32768015
pii: S0019-4832(20)30094-8
doi: 10.1016/j.ihj.2020.05.004
pmc: PMC7411101
pii:
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
166-171Informations de copyright
Copyright © 2020 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest All authors have none to declare.
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