TY - JOUR
T1 - Transradial versus transfemoral intervention in non-ST-segment elevation acute coronary syndrome patients undergoing percutaneous coronary intervention
T2 - The Korean transradial intervention registry of 1 285 patients
AU - Lee, Min Ho
AU - Bang, Duk Won
AU - Park, Byung Won
AU - Cho, Byung Ryul
AU - Rha, Seung Woon
AU - Jeong, Myung Ho
AU - Yoon, Junghan
AU - Suh, Jon
AU - Han, Kyoo Rok
AU - Hyon, Min Su
N1 - Funding Information:
This study was supported by the Soonchunhyang University Research Fund. The funder had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.
Publisher Copyright:
© 2018 Clinics Cardive Publishing (PTY)Ltd. All Rights Reserved.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Abstract Introduction: Although the implementation of transradial intervention (TRI) has increased over the last few years, there are limited data on the impact of TRI on efficacy and safety in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). We sought to compare one-year clinical outcomes and bleeding complications of TRI with those of transfemoral intervention (TFI) in patients with NSTE-ACS. Methods: The Korean TRI registry was a cohort of 20 centres from 2012 to 2015. The primary efficacy endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death (CD), non-fatal myocardial infarction (MI) and repeat revascularisation (RR). Among the 1 319 patients with NSTE-ACS, 1 285 were finally analysed after excluding 34 due to lack of follow-up data. The patients were divided into TRI and TFI groups according to the final access site. Results: At one-year follow up, the TRI group showed a significantly lower rate of MACE, and a marginally significantly lower rate of CD than the TFI group in the crude population. However, in propensity-score matched analysis, the rate of MACE did not differ between the TRI and TFI groups. Regarding bleeding complications, the TRI group was associated with significantly lower rates of major bleeding in both the crude and matched populations. Independent predictors of MACE were chronic kidney disease (CKD) and multi-vessel disease (MVD). Conclusions: In patients with NSTE-ACS, TRI was associated with favourable one-year clinical outcomes and lower bleeding complications compared to TFI. Independent predictors of MACE were clinical and angiographic profiles (CKD, MVD) rather than vascular access sites.
AB - Abstract Introduction: Although the implementation of transradial intervention (TRI) has increased over the last few years, there are limited data on the impact of TRI on efficacy and safety in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). We sought to compare one-year clinical outcomes and bleeding complications of TRI with those of transfemoral intervention (TFI) in patients with NSTE-ACS. Methods: The Korean TRI registry was a cohort of 20 centres from 2012 to 2015. The primary efficacy endpoint was major adverse cardiovascular events (MACE), defined as a composite of cardiac death (CD), non-fatal myocardial infarction (MI) and repeat revascularisation (RR). Among the 1 319 patients with NSTE-ACS, 1 285 were finally analysed after excluding 34 due to lack of follow-up data. The patients were divided into TRI and TFI groups according to the final access site. Results: At one-year follow up, the TRI group showed a significantly lower rate of MACE, and a marginally significantly lower rate of CD than the TFI group in the crude population. However, in propensity-score matched analysis, the rate of MACE did not differ between the TRI and TFI groups. Regarding bleeding complications, the TRI group was associated with significantly lower rates of major bleeding in both the crude and matched populations. Independent predictors of MACE were chronic kidney disease (CKD) and multi-vessel disease (MVD). Conclusions: In patients with NSTE-ACS, TRI was associated with favourable one-year clinical outcomes and lower bleeding complications compared to TFI. Independent predictors of MACE were clinical and angiographic profiles (CKD, MVD) rather than vascular access sites.
KW - Acute coronary syndrome
KW - Femoral artery
KW - Myocardial infarction
KW - Percutaneous coronary intervention
KW - Radial artery
UR - http://www.scopus.com/inward/record.url?scp=85060999712&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85060999712&partnerID=8YFLogxK
U2 - 10.5830/CVJA-2018-047
DO - 10.5830/CVJA-2018-047
M3 - Article
C2 - 30398512
AN - SCOPUS:85060999712
VL - 29
SP - 374
EP - 380
JO - Cardiovascular Journal of Africa
JF - Cardiovascular Journal of Africa
SN - 1995-1892
IS - 6
ER -