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Despite widespread adoption of transradial approach for percutaneous coronary intervention (PCI) in clinical practice, its role in women remains to be defined. This study sought to compare both hospital costs and clinical outcomes for transradial intervention (TRI) and transfemoral intervention (TFI) in women in China.
In this retrospective study, 1392 women who underwent PCI in Fuwai Hospital, Beijing, China between 2010-01-01 and 2010-12-31 were enrolled (TRI: n=1014, TFI: n=378). Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control for potential bias caused by treatment selection.
Women undergoing TRI were younger, more likely to receive PCI for single-vessel lesions, and were less likely to undergo the procedure for double-vessel lesions or left main diseases. After adjusting for all observed characteristics using the propensity score inverse probability weighting method, TRI was associated with a cost saving of ¥7474 (approximately $1150, 95% confidence interval [CI]：¥2993-¥11,624, p<0.0001). Such differences were mainly driven by lower PCI-related costs. Moreover, TRI patients had shorter length of stay (adjusted difference -1.2 days, 95% CI -1.7 to -0.6, p<0.001), fewer major adverse cardiac events (adjusted odds ratio=0.35，95% CI：0.91-0.63, p<0.001), and less post-PCI bleeding (adjusted OR 0.46, 95% CI 0.30-0.71, p<0.001).
Compared with TFI, the adoption of transradial approach in women was associated with significantly reduced total hospital costs and more favorable clinical outcomes.