Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population

Hu Li, Seung Woon Rha, Byoung Geol Choi, Min Suk Shim, Se Yeon Choi, Cheol Ung Choi, Eung Ju Kim, Dong Joo Oh, Byung Ryul Cho, Moo Hyun Kim, Doo Il Kim, Myung Ho Jeong, Sang Yong Yoo, Sang Sik Jeong, Byung Ok Kim, Min Su Hyun, Young Jin Youn, Junghan Yoon

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Abstract

Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). Results: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

Original languageEnglish
Pages (from-to)716-726
Number of pages11
JournalKorean Journal of Internal Medicine
Volume33
Issue number4
DOIs
Publication statusPublished - 2018 Jul 1

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Drug-Eluting Stents
Percutaneous Coronary Intervention
Myocardial Infarction
Population
Incidence
Hemorrhage
Propensity Score
Hematoma
Blood Vessels
ST Elevation Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Li, Hu ; Rha, Seung Woon ; Choi, Byoung Geol ; Shim, Min Suk ; Choi, Se Yeon ; Choi, Cheol Ung ; Kim, Eung Ju ; Oh, Dong Joo ; Cho, Byung Ryul ; Kim, Moo Hyun ; Kim, Doo Il ; Jeong, Myung Ho ; Yoo, Sang Yong ; Jeong, Sang Sik ; Kim, Byung Ok ; Hyun, Min Su ; Youn, Young Jin ; Yoon, Junghan. / Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population. In: Korean Journal of Internal Medicine. 2018 ; Vol. 33, No. 4. pp. 716-726.
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title = "Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population",
abstract = "Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9{\%}) were compared to those of the TFI group (n = 469, 28.1{\%}). Results: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4{\%} vs. 0.5{\%}, p = 0.003), target vessel revascularization (6.4{\%} vs. 0.5{\%}, p = 0.003), and major adverse cardiac events (MACE; 11.6{\%} vs. 4.6{\%}, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.",
author = "Hu Li and Rha, {Seung Woon} and Choi, {Byoung Geol} and Shim, {Min Suk} and Choi, {Se Yeon} and Choi, {Cheol Ung} and Kim, {Eung Ju} and Oh, {Dong Joo} and Cho, {Byung Ryul} and Kim, {Moo Hyun} and Kim, {Doo Il} and Jeong, {Myung Ho} and Yoo, {Sang Yong} and Jeong, {Sang Sik} and Kim, {Byung Ok} and Hyun, {Min Su} and Youn, {Young Jin} and Junghan Yoon",
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Li, H, Rha, SW, Choi, BG, Shim, MS, Choi, SY, Choi, CU, Kim, EJ, Oh, DJ, Cho, BR, Kim, MH, Kim, DI, Jeong, MH, Yoo, SY, Jeong, SS, Kim, BO, Hyun, MS, Youn, YJ & Yoon, J 2018, 'Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population', Korean Journal of Internal Medicine, vol. 33, no. 4, pp. 716-726. https://doi.org/10.3904/kjim.2016.316

Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population. / Li, Hu; Rha, Seung Woon; Choi, Byoung Geol; Shim, Min Suk; Choi, Se Yeon; Choi, Cheol Ung; Kim, Eung Ju; Oh, Dong Joo; Cho, Byung Ryul; Kim, Moo Hyun; Kim, Doo Il; Jeong, Myung Ho; Yoo, Sang Yong; Jeong, Sang Sik; Kim, Byung Ok; Hyun, Min Su; Youn, Young Jin; Yoon, Junghan.

In: Korean Journal of Internal Medicine, Vol. 33, No. 4, 01.07.2018, p. 716-726.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Transradial versus transfemoral intervention in st-segment elevation myocardial infarction patients in korean population

AU - Li, Hu

AU - Rha, Seung Woon

AU - Choi, Byoung Geol

AU - Shim, Min Suk

AU - Choi, Se Yeon

AU - Choi, Cheol Ung

AU - Kim, Eung Ju

AU - Oh, Dong Joo

AU - Cho, Byung Ryul

AU - Kim, Moo Hyun

AU - Kim, Doo Il

AU - Jeong, Myung Ho

AU - Yoo, Sang Yong

AU - Jeong, Sang Sik

AU - Kim, Byung Ok

AU - Hyun, Min Su

AU - Youn, Young Jin

AU - Yoon, Junghan

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). Results: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

AB - Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). Results: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

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