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.
| Original language | English |
|---|---|
| Pages (from-to) | 1588-1595 |
| Number of pages | 8 |
| Journal | American Journal of Cardiology |
| Volume | 117 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2016 May 15 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Comparison of frequency of bleeding and major adverse cardiac events after transradial versus transfemoral intervention in the recent antiplatelet era. / 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.
In: American Journal of Cardiology, Vol. 117, No. 10, 15.05.2016, p. 1588-1595.Research output: Contribution to journal › Article
TY - JOUR
T1 - Comparison of frequency of bleeding and major adverse cardiac events after transradial versus transfemoral intervention in the recent antiplatelet era
AU - Choe, Jeong Cheon
AU - Cha, Kwang Soo
AU - Choi, Jong Hyun
AU - Kim, Bo Won
AU - Park, Jin Sup
AU - Lee, Hye Won
AU - Oh, Jun Hyok
AU - Choi, Jung Hyun
AU - Lee, Han Cheol
AU - Hong, Taek Jong
AU - Youn, Young Jin
AU - Lee, Seung Hwan
AU - Cho, Byung Ryul
AU - Kim, Doo Il
AU - Han, Kyoo Rok
AU - Jeong, Myung Ho
AU - Yoon, Junghan
PY - 2016/5/15
Y1 - 2016/5/15
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84961798404&partnerID=8YFLogxK
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U2 - 10.1016/j.amjcard.2016.02.033
DO - 10.1016/j.amjcard.2016.02.033
M3 - Article
C2 - 27026640
AN - SCOPUS:84961798404
VL - 117
SP - 1588
EP - 1595
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 10
ER -