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Comparison of transradial and transfemoral coronary intervention in octogenarians with acute myocardial infarction.
- Source :
-
International journal of cardiology [Int J Cardiol] 2016 Jan 01; Vol. 202, pp. 419-24. Date of Electronic Publication: 2015 Sep 07. - Publication Year :
- 2016
-
Abstract
- Background: The transradial (TR) approach for percutaneous coronary intervention (PCI) is challenging and associated with failure in elderly patients. We compared the TR and transfemoral (TF) approaches in patients>80 years with acute myocardial infarction (MI) undergoing PCI.<br />Methods: A total of 1945 (7.2%) octogenarians were enrolled from among 27,129 patients in the Korea Acute Myocardial Infarction Registry. The TR group (n=336, 17.3%) was compared with the TF group (n=1609, 82.7%) in the overall and propensity-matched cohorts with respect to procedural success, complications, in-hospital mortality, and one-year mortality and total major adverse cardiac event (MACE; death, MI, and revascularization) rate.<br />Results: In the overall cohort, the TR group had lower incidence of Killip class III or IV compared to the TF group. The disease extent and lesion severity were similar between groups, as was the procedural success rate (97.7% vs. 98.3%); however, in-hospital complications were significantly lower in the TR group (8.1% vs. 20.3%). In-hospital mortality was significantly lower in the TR group than the TF group (3.4% vs. 11.4%), as were the one-year mortality and total MACE (9.8% vs. 18.4% and 13% vs. 21.9%, respectively). These outcomes were consistent in the propensity-matched cohort. The TR approach was found to be a significant predictor of low in-hospital mortality (OR 0.355, 95% CI 0.139-0.907), but not of one-year mortality (OR 0.644, 95% CI 0.334-1.240).<br />Conclusions: In octogenarians with acute MI undergoing PCI, the TR approach was more effective than the TF approach as it had lower complication rate and better clinical outcomes with comparable procedural success.<br /> (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Age Factors
Aged, 80 and over
Angioplasty, Balloon, Coronary adverse effects
Angioplasty, Balloon, Coronary statistics & numerical data
Female
Femoral Artery surgery
Hospital Mortality
Humans
Incidence
Male
Myocardial Infarction mortality
Percutaneous Coronary Intervention adverse effects
Percutaneous Coronary Intervention statistics & numerical data
Propensity Score
Radial Artery surgery
Republic of Korea epidemiology
Treatment Outcome
Angioplasty, Balloon, Coronary methods
Myocardial Infarction surgery
Percutaneous Coronary Intervention methods
Subjects
Details
- Language :
- English
- ISSN :
- 1874-1754
- Volume :
- 202
- Database :
- MEDLINE
- Journal :
- International journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 26433163
- Full Text :
- https://doi.org/10.1016/j.ijcard.2015.09.004