Comparison of frequency of bleeding and major adverse cardiac events after transradial versus transfemoral intervention in the recent antiplatelet era

Jeong Cheon Choe, Kwang Soo Cha, Jong Hyun Choi, Bo Won Kim, Jin Sup Park, Hye Won Lee, Jun Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Taek Jong Hong, Youngjin Youn, Seunghwan Lee, Byung Ryul Cho, Doo Il Kim, Kyoo Rok Han, Myung Ho Jeong, Junghan Yoon

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)1588-1595
Number of pages8
JournalAmerican Journal of Cardiology
Volume117
Issue number10
DOIs
Publication statusPublished - 2016 May 15

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Hemorrhage
Percutaneous Coronary Intervention
Propensity Score
Myocardial Revascularization
Kaplan-Meier Estimate
Stents
Registries
Thrombosis
Survival Rate
Odds Ratio
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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, Youngjin ; Lee, Seunghwan ; Cho, Byung Ryul ; Kim, Doo Il ; Han, Kyoo Rok ; Jeong, Myung Ho ; Yoon, Junghan. / Comparison of frequency of bleeding and major adverse cardiac events after transradial versus transfemoral intervention in the recent antiplatelet era. In: American Journal of Cardiology. 2016 ; Vol. 117, No. 10. pp. 1588-1595.
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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.",
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Choe, JC, Cha, KS, Choi, JH, Kim, BW, Park, JS, Lee, HW, Oh, JH, Choi, JH, Lee, HC, Hong, TJ, Youn, Y, Lee, S, Cho, BR, Kim, DI, Han, KR, Jeong, MH & Yoon, J 2016, 'Comparison of frequency of bleeding and major adverse cardiac events after transradial versus transfemoral intervention in the recent antiplatelet era', American Journal of Cardiology, vol. 117, no. 10, pp. 1588-1595. https://doi.org/10.1016/j.amjcard.2016.02.033

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, Youngjin; Lee, Seunghwan; 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 journalArticle

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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

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AU - Youn, Youngjin

AU - Lee, Seunghwan

AU - Cho, Byung Ryul

AU - Kim, Doo Il

AU - Han, Kyoo Rok

AU - Jeong, Myung Ho

AU - Yoon, Junghan

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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.

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