Complete transitioning to the radial approach for primary percutaneous coronary intervention: A real-world single-center registry of 1808 consecutive patients with acute ST-elevation myocardial infarction

Sasko Kedev, Oliver Kalpak, Surya Dharma, Slobodan Antov, Jorgo Kostov, Hristo Pejkov, Igor Spiroski

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)

Abstract

OBJECTIVES: To compare the short- and long-term outcomes of transradial approach (TRA) versus transfemoral approach (TFA) for primary percutaneous coronary intervention (PPCI) during a complete institutional transition from TFA to TRA. METHODS AND RESULTS: An all-comer population of ST-elevation myocardial infarction (STEMI) patients (n≤1808) who underwent PPCI using TRA (n≤1162) and TFA (n≤646) from October 2007 to December 2010 were enrolled. TRA was used in 25% of PPCIs by 2007 and in 96% of PPCIs in 2010. Primary endpoints were cardiovascular death and major adverse cardiac event (MACE), defined as a composite of death, stroke, reinfarction, and target vessel revascularization at 30 days and 1 year. At 30 days, TRA compared to TFA was associated with a significant reduction of cardiovascular mortality (5.2% vs 10.5%; P<.001), significant MACE reduction (7.3% vs 12.5%; P<.001), fewer access-site complications (0.9% vs 8.2%; P<.001), and lower TIMI major bleeding (1.1% vs 4.3%; P<.001). At 1 year, the cardiovascular mortality and MACE rates were also in favor of the TRA group (6.9% vs 11.5%; P<.001 and 11.6% vs 20.1%; P<.001), respectively. CONCLUSION: Complete transition from femoral access to a preferred radial access is safe and effective for STEMI patients undergoing PPCI, with a favorable effect on short- and long-term outcomes.

Original languageEnglish
Pages (from-to)475-482
Number of pages8
JournalJournal of Invasive Cardiology
Volume26
Issue number9
Publication statusPublished - 1 Jan 2014

Keywords

  • primary percutaneous coronary intervention
  • ST-elevation myocardial infarction
  • transradial approach

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