6 research outputs found

    Comparison of Short- and Medium-Term Clinical Outcomes between Transradial Approach and Transfemoral Approach in a High-Volume PCI Heart Center in China

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    <div><p>Background</p><p>Transradial approach (TRA) outweighed transfemoral approach (TFA) in acute coronary syndrome patients because the former has better short-term outcomes in high-volume percutaneous coronary intervention (PCI) centers. Our study was one of the limited studies specifically in comparing the short- and medium-term effects of TRA and those of TFA in patients undergoing elective PCIs.</p><p>Methods</p><p>A total of 21,242 patients who underwent elective PCI with stent implantation were included. Using propensity score methodology, 1,634 patient pairs were matched. Major clinical outcomes and PCI-related complications between TRA and TFA were compared.</p><p>Results</p><p>In the propensity score-matched patients, the rates of in-hospital net adverse clinical events, which included death, myocardial infarction (MI), target vessel revascularization (TVR), stroke, and major bleeding, were much lower with TRA than with TFA (1.8% vs. 3.9%, <i>P</i> < 0.001). This difference was mainly due to the lower rate of major bleeding (0.6% vs. 1.8%, <i>P</i> < 0.001) and the decreased rate of MI (1.1% vs. 1.9%, <i>P</i> = 0.060). PCI-related dissection and thrombosis were similar between the TRA and TFA groups (both <i>P</i> > 0.05). Meanwhile, one-year incidence rates of major adverse cardiovascular events, which included death, MI, and TVR, were also similar (4.1% vs. 4.9%, <i>P</i> = 0.272) in TRA and TFA. Multivariable regression analyses showed that TRA was an independent predictor of the low rate of in-hospital net adverse clinical events (odds ratio, 0.53; 95% confidence interval, 0.40 to 0.71), but not of major adverse cardiovascular events at one-year follow-up (hazard ratio, 1.01; 95% confidence interval, 0.96 to 1.06).</p><p>Conclusions</p><p>In patients undergoing elective PCI, TRA patients had lower rates of in-hospital net adverse clinical outcomes compared with TFA patients. TRA might be recommended as a routine approach in high-volume PCI hospitals for elective PCIs.</p></div

    Major outcomes.

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    <p>Data represented as n (%) or median (25th quartile, 75th quartile).</p><p>MACE, major adverse clinical event; MI, myocardial infarction; NACE, net adverse clinical events; TVR, target vessel revascularization; TFA, transfemoral approach; TRA, transradial approach.</p><p>Major outcomes.</p

    The adjusted rates for the major endpoint of TRA vs. TFA.

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    <p>CI, confidence interval; HR, hazard ratio; MACE, major adverse cardiovascular events; NACE, net adverse clinical events; OR, odds ratio; TFA, transfemoral approach; TRA,transradial approach.</p><p>The adjusted rates for the major endpoint of TRA vs. TFA.</p

    Angiographic characteristics and procedure outcomes.

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    <p>Data represented as proportion, mean ┬▒SD or median (25<sup>th</sup> quartile, 75<sup>th</sup> quartile).</p><p>*Compared in the lesion level.</p><p>CTO, chronic total occlusion; LM, left main branch; IABP, intra-aortic balloon pump; TFA, transfemoral approach; TIMI, Thrombolysis in myocardial infarction; TRA, transradial approach.</p><p>Angiographic characteristics and procedure outcomes.</p

    Baseline characteristics.

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    <p>Data represented as n (%) or mean ┬▒ SD.</p><p>CABG, coronary artery bypass graft; GP IIb/IIIa, Glycoproterin IIb/IIIa inhibitor; LMWH, low molecular weight heparin; LVEF, left ventricle ejection fraction; MI, myocardial infarction; NSTEMI, non ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; TFA, transfemoral approach; TRA, transradial approach; PCI, percutenous coronary intervention.</p><p>Baseline characteristics.</p