Transradial Primary Percutaneous Coronary Intervention is Associated with Low Rates of Clinical and Cardiovascular Events in Patients with Acute ST Elevation Myocardial Infarction

摘要

OBJECTIVE: The transradial (TR) approach has been increasingly employed as an alternative approach to the transfemoral (TF) approach in percutaneous coronary intervention (PCI). We aimed to investigate the impact of TR approach on clinical outcomes in 1st and 6th months compared with a TF approach in patients with ST elevation myocardial infarction (STEMI) undergoing primary PCI.METHODS: Three hundred fifteen patients who underwent primary PCI for STEMI were evaluated retrospectively. TR approach group consisted of 55 patients (19 females, mean age: 55±10 years), and TF approach group consisted of 74 patients (21 females, mean-age 53±9 years). Endpoints included the rates of major adverse cardiovascular events (MACE: death, recurrent MI, target lesion revascularization and stroke) and net adverse clinical events (NACE: MACE and bleeding) at the first and six-months.RESULTS: The two groups were similar in terms of baseline clinical characteristics. Arterial cannulation, door-to-balloon and total-procedure times, and access-site crossover rates were not significantly different between TR approach and TF approach groups (p=0.966, p=0.139, p=0.393, and p=0.197; respectively). While infarction localizations and the numbers of treated vessel were similar in both groups, the use of tirofiban was higher (p=0.025) and hospital stay was lower (p=0.017) in TR approach. The 30-day rate of MACE was lower in TR approach than that in TF approach, but not statistically significant (p=0.119). The 30-day rate of NACE was significantly lower in TF approach (p=0.006). At the 6th month, the TR approach had significantly lower rates of MACE (p=0.039) and NACE (p=0.002) as compared to TF approach. CONCLUSION: TR approach had similar procedural times and was associated with lower clinical and cardiovascular events in patients with STEMI undergoing primary PCI as compared to those of TF approach.