1. Comparison of Frequency of Bleeding and Major Adverse Cardiac Events After Transradial Versus Transfemoral Intervention in the Recent Antiplatelet Era.
- Author
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Choe, Jeong Cheon, Cha, Kwang Soo, Choi, Jong Hyun, Kim, Bo Won, Park, Jin Sup, Lee, Hye Won, Oh, Jun-Hyok, Choi, Jung Hyun, Lee, Han Cheol, Hong, Taek Jong, Youn, Young Jin, Lee, Seung Hwan, Cho, Byung Ryul, Kim, Doo Il, Han, Kyoo Rok, Jeong, Myung Ho, Yoon, Junghan, and Korea Transradial Coronary Intervention (KOTRI) Prospective Registry Investigators
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CORONARY restenosis prevention , *CARDIOVASCULAR system , *COMPARATIVE studies , *FEMORAL artery , *HEMORRHAGE , *LONGITUDINAL method , *RESEARCH methodology , *MEDICAL care , *MEDICAL cooperation , *MYOCARDIAL infarction , *PROBABILITY theory , *RESEARCH , *SURGICAL complications , *SURVIVAL , *TIME , *EVALUATION research , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *DISEASE incidence , *ACQUISITION of data , *PLATELET aggregation inhibitors , *RADIAL artery , *CORONARY angiography , *THERAPEUTICS ,MYOCARDIAL infarction-related mortality - Abstract
The transradial approach is increasingly used for percutaneous coronary intervention (PCI), and we therefore aimed to compare the clinical outcomes after transradial intervention (TRI) and transfemoral intervention (TFI) in all patients undergoing PCI. Among 6,973 patients enrolled in a nationwide, prospective, multicenter registry (February 2013 to September 2013), 1,860 underwent TRI (n = 1,445, 77.7%) and TFI (n = 415, 22.3%). Bleeding and major adverse cardiac events (MACE; death, myocardial infarction, revascularization, or stent thrombosis) were compared. Bleeding occurred in 42 patients (2.3%) and was significantly less likely in the TRI versus TFI group (overall cohort: 1.5% vs 4.8%, p = 0.001; propensity score-matched: n = 728, 2.7% vs 5.2%, p = 0.048). Multivariate regression revealed that TRI was negatively associated with bleeding (odds ratio 0.42, 95% CI 0.21 to 0.83, p = 0.013). MACE occurred in 152 patients (8.2%). Kaplan-Meier estimates showed higher MACE-free survival rates in the TRI versus TFI group (overall cohort: 93.3% vs 86.7%, log-rank p = 0.026; propensity score-matched: 91.8% vs 86.5%, log-rank p = 0.04). Cox proportional analysis demonstrated that TRI independently predicted improved MACE (hazard ratio 0.64, 95% CI 0.43 to 0.91, p = 0.024). In conclusion, TRI is associated with reduced bleeding rates and better clinical outcomes than TFI in all patients undergoing PCI. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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