In-hospital outcome differences between transradial and transfemoral coronary approaches: Data from the Korean percutaneous coronary intervention registry

Sung Gyun Ahn, Jun Won Lee, Young Jin Youn, Seung Hwan Lee, Jang Hyun Cho, Woong Chol Kang, Jong Pil Park, Won Yong Shin, Seong Hoon Lim, Yu Jeong Choi, Kyungsoo Kim, Do Sun Lim, Woojung Chun, Ju Han Kim, Junghan Yoon

Research output: Contribution to journalArticle

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Abstract

Objectives: We aimed to investigate specific subgroups in which the benefit of transradial coronary interventions (TRIs) would be enhanced. Background: The advantage of TRIs over transfemoral coronary interventions (TFIs) might differ according to a given clinical condition, urgency of the procedure, and operator volume pattern. Methods: Using a cohort from the 2014 Korean Percutaneous Coronary Intervention Registry, in-hospital outcomes of the TRI group (n = 22,993) were matched to those of the TFI group (n = 15,581). After propensity score matching, the composite endpoints between the groups and subgroups for all-cause death, nonfatal myocardial infarctions (MIs), or transfusions were analyzed. Results: The composite endpoints occurred less frequently in the TRI group than the TFI group [2.1% vs. 5.5%, OR 0.63, 95% CI 0.55–0.72]. The TRI group had a lower rate of death (OR 0.44, 95% CI 0.33–0.60) and nonfatal MI (OR 0.66, 95% CI 0.54–0.81) than the TFI group. The TRI group required fewer transfusions than the TFI group (OR 0.72, 95% CI 0.59–0.88). TRI benefits were consistent across subgroups except patients with chronic kidney disease and those treated in low tertile PCI volume centers. The favorable outcome of TRI was greater in the elderly (≥75 years), patients with ST-elevation MI, those who underwent emergent PCI, and those treated in high tertile PCI volume hospitals (P for the interaction <0.001 for all). Conclusions: Compared to TFI, TRI had favorable composite in-hospital outcomes. TRI benefits were pronounced in high-risk clinical settings and in high PCI volume centers.

Original languageEnglish
Pages (from-to)378-384
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume94
Issue number3
DOIs
Publication statusPublished - 2019 Sep 1

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Percutaneous Coronary Intervention
Registries
Myocardial Infarction
Propensity Score
Chronic Renal Insufficiency
Cause of Death
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Ahn, Sung Gyun ; Lee, Jun Won ; Youn, Young Jin ; Lee, Seung Hwan ; Cho, Jang Hyun ; Kang, Woong Chol ; Park, Jong Pil ; Shin, Won Yong ; Lim, Seong Hoon ; Choi, Yu Jeong ; Kim, Kyungsoo ; Lim, Do Sun ; Chun, Woojung ; Kim, Ju Han ; Yoon, Junghan. / In-hospital outcome differences between transradial and transfemoral coronary approaches : Data from the Korean percutaneous coronary intervention registry. In: Catheterization and Cardiovascular Interventions. 2019 ; Vol. 94, No. 3. pp. 378-384.
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title = "In-hospital outcome differences between transradial and transfemoral coronary approaches: Data from the Korean percutaneous coronary intervention registry",
abstract = "Objectives: We aimed to investigate specific subgroups in which the benefit of transradial coronary interventions (TRIs) would be enhanced. Background: The advantage of TRIs over transfemoral coronary interventions (TFIs) might differ according to a given clinical condition, urgency of the procedure, and operator volume pattern. Methods: Using a cohort from the 2014 Korean Percutaneous Coronary Intervention Registry, in-hospital outcomes of the TRI group (n = 22,993) were matched to those of the TFI group (n = 15,581). After propensity score matching, the composite endpoints between the groups and subgroups for all-cause death, nonfatal myocardial infarctions (MIs), or transfusions were analyzed. Results: The composite endpoints occurred less frequently in the TRI group than the TFI group [2.1{\%} vs. 5.5{\%}, OR 0.63, 95{\%} CI 0.55–0.72]. The TRI group had a lower rate of death (OR 0.44, 95{\%} CI 0.33–0.60) and nonfatal MI (OR 0.66, 95{\%} CI 0.54–0.81) than the TFI group. The TRI group required fewer transfusions than the TFI group (OR 0.72, 95{\%} CI 0.59–0.88). TRI benefits were consistent across subgroups except patients with chronic kidney disease and those treated in low tertile PCI volume centers. The favorable outcome of TRI was greater in the elderly (≥75 years), patients with ST-elevation MI, those who underwent emergent PCI, and those treated in high tertile PCI volume hospitals (P for the interaction <0.001 for all). Conclusions: Compared to TFI, TRI had favorable composite in-hospital outcomes. TRI benefits were pronounced in high-risk clinical settings and in high PCI volume centers.",
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In-hospital outcome differences between transradial and transfemoral coronary approaches : Data from the Korean percutaneous coronary intervention registry. / Ahn, Sung Gyun; Lee, Jun Won; Youn, Young Jin; Lee, Seung Hwan; Cho, Jang Hyun; Kang, Woong Chol; Park, Jong Pil; Shin, Won Yong; Lim, Seong Hoon; Choi, Yu Jeong; Kim, Kyungsoo; Lim, Do Sun; Chun, Woojung; Kim, Ju Han; Yoon, Junghan.

In: Catheterization and Cardiovascular Interventions, Vol. 94, No. 3, 01.09.2019, p. 378-384.

Research output: Contribution to journalArticle

TY - JOUR

T1 - In-hospital outcome differences between transradial and transfemoral coronary approaches

T2 - Data from the Korean percutaneous coronary intervention registry

AU - Ahn, Sung Gyun

AU - Lee, Jun Won

AU - Youn, Young Jin

AU - Lee, Seung Hwan

AU - Cho, Jang Hyun

AU - Kang, Woong Chol

AU - Park, Jong Pil

AU - Shin, Won Yong

AU - Lim, Seong Hoon

AU - Choi, Yu Jeong

AU - Kim, Kyungsoo

AU - Lim, Do Sun

AU - Chun, Woojung

AU - Kim, Ju Han

AU - Yoon, Junghan

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objectives: We aimed to investigate specific subgroups in which the benefit of transradial coronary interventions (TRIs) would be enhanced. Background: The advantage of TRIs over transfemoral coronary interventions (TFIs) might differ according to a given clinical condition, urgency of the procedure, and operator volume pattern. Methods: Using a cohort from the 2014 Korean Percutaneous Coronary Intervention Registry, in-hospital outcomes of the TRI group (n = 22,993) were matched to those of the TFI group (n = 15,581). After propensity score matching, the composite endpoints between the groups and subgroups for all-cause death, nonfatal myocardial infarctions (MIs), or transfusions were analyzed. Results: The composite endpoints occurred less frequently in the TRI group than the TFI group [2.1% vs. 5.5%, OR 0.63, 95% CI 0.55–0.72]. The TRI group had a lower rate of death (OR 0.44, 95% CI 0.33–0.60) and nonfatal MI (OR 0.66, 95% CI 0.54–0.81) than the TFI group. The TRI group required fewer transfusions than the TFI group (OR 0.72, 95% CI 0.59–0.88). TRI benefits were consistent across subgroups except patients with chronic kidney disease and those treated in low tertile PCI volume centers. The favorable outcome of TRI was greater in the elderly (≥75 years), patients with ST-elevation MI, those who underwent emergent PCI, and those treated in high tertile PCI volume hospitals (P for the interaction <0.001 for all). Conclusions: Compared to TFI, TRI had favorable composite in-hospital outcomes. TRI benefits were pronounced in high-risk clinical settings and in high PCI volume centers.

AB - Objectives: We aimed to investigate specific subgroups in which the benefit of transradial coronary interventions (TRIs) would be enhanced. Background: The advantage of TRIs over transfemoral coronary interventions (TFIs) might differ according to a given clinical condition, urgency of the procedure, and operator volume pattern. Methods: Using a cohort from the 2014 Korean Percutaneous Coronary Intervention Registry, in-hospital outcomes of the TRI group (n = 22,993) were matched to those of the TFI group (n = 15,581). After propensity score matching, the composite endpoints between the groups and subgroups for all-cause death, nonfatal myocardial infarctions (MIs), or transfusions were analyzed. Results: The composite endpoints occurred less frequently in the TRI group than the TFI group [2.1% vs. 5.5%, OR 0.63, 95% CI 0.55–0.72]. The TRI group had a lower rate of death (OR 0.44, 95% CI 0.33–0.60) and nonfatal MI (OR 0.66, 95% CI 0.54–0.81) than the TFI group. The TRI group required fewer transfusions than the TFI group (OR 0.72, 95% CI 0.59–0.88). TRI benefits were consistent across subgroups except patients with chronic kidney disease and those treated in low tertile PCI volume centers. The favorable outcome of TRI was greater in the elderly (≥75 years), patients with ST-elevation MI, those who underwent emergent PCI, and those treated in high tertile PCI volume hospitals (P for the interaction <0.001 for all). Conclusions: Compared to TFI, TRI had favorable composite in-hospital outcomes. TRI benefits were pronounced in high-risk clinical settings and in high PCI volume centers.

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