Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population

Hu Li, Seung-Woon Rha, Byoung Geol Choi, Min Suk Shim, Se Yeon Choi, Cheol Ung Choi, Eung Ju Kim, Dong Joo Oh, Byung Ryul Cho, Moo Hyun Kim, Doo Il Kim, Myung Ho Jeong, Sang Yong Yoo, Sang Sik Jeong, Byung Ok Kim, Min Su Hyun, Young Jin Youn, Junghan Yoon

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Abstract

Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). Results: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

Original languageEnglish
Pages (from-to)716-726
Number of pages11
JournalKorean Journal of Internal Medicine
Volume33
Issue number4
DOIs
Publication statusPublished - 2018 Jul 1

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Keywords

  • Access site
  • ST elevation myocardial infarction
  • Transfemoral intervention
  • Transradial intervention
  • Vascular complications

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Li, H., Rha, S-W., Choi, B. G., Shim, M. S., Choi, S. Y., Choi, C. U., Kim, E. J., Oh, D. J., Cho, B. R., Kim, M. H., Kim, D. I., Jeong, M. H., Yoo, S. Y., Jeong, S. S., Kim, B. O., Hyun, M. S., Youn, Y. J., & Yoon, J. (2018). Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population. Korean Journal of Internal Medicine, 33(4), 716-726. https://doi.org/10.3904/kjim.2016.316