Author + information
- Matthew Cavendera,b,
- Michelle ODonoghuea,b,
- Ruchira Glasera,b,
- Julia Kudera,b,
- Marc Sabatinea,b and
- David Morrowa,b
Background: Studies of radial access for angiography have raised concern of an increased risk of stroke (CVA); however, the infrequency of CVA in this setting has limited understanding of the relationship.
Methods: We analyzed the 3,503 patients with ACS in the LATITUDE-TIMI 60 trial to determine the association between access and events. An independent CEC adjudicated all ischemic events (including CVA) and site investigators prospectively reported bleeding using standardized definitions. A Cox model that included potential confounders was used to assess the association between access site and outcomes.
Results: A total of 3,320 pts underwent angiography for the index ACS event. Radial access was used in the majority (63%, n=2081) and was the predominant access site in all geographic regions except North America (41%, p<0.001). Radial access was used less frequently in patients with prior MI, CABG, and heart failure. There was no association between radial versus femoral access site and the incidence of CVA (0.7% vs. 1.0%, HRadj 0.82, 95%CI 0.38-1.80, p=0.63), CV death/MI (5.9% vs. 7.0%, HRadj0.86, 95%CI 0.65—1.14) or TIMI major/minor bleeding (1.7% vs. 2.2%, HRadj0.78, p=0.33).
Conclusions: In this large, contemporary cohort of patients with ACS, there was no significant association between the access site used for angiography and CVA; however rates of both CVA and bleeding were numerically lower with radial than femoral access. These data lend support for the safety of radial access in patients with ACS.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Vascular Access and Hemostasis Issues
Abstract Category: 26. Interventional Cardiology: Vascular Access and Complications
Presentation Number: 1192-122
- 2017 American College of Cardiology Foundation