Author + information
- Dmitri Baklanov,
- Lisa Kaltenbach,
- Steven Marso,
- Sumeet Subherwal,
- Dmitriy Feldman,
- Kirk Garratt,
- Jeptha Curtis,
- John Messenger and
- Sunil Rao
Transradial (TRI) percutaneous coronary intervention (PCI) is associated with reduced risk of bleeding and vascular complications compared with femoral PCI (FPCI). Studies have suggested that TRI may reduce mortality among patients with ST–elevation myocardial infarction (STEMI), but its use in the United States has not been well described.
We examined 294,769 patients undergoing emergent PCI for STEMI at 1204 hospitals in the CathPCI Registry® between 2007 and 2011. Patients were grouped according to vascular access site. The temporal trend in the rate of TRI vs. FPCI was determined. An inverse probability weighting analysis incorporating propensity scores was used to compare procedural success, post–PCI bleeding, door–to–balloon times, and inhospital mortality between TRI and FPCI.
Over the 5–year period studied, the use of TRI in STEMI has increased from 0.9% to 6.4% (p<0.0001). There was no difference in procedural success between TRI and FPCI. TRI was associated with longer median door–to–balloon time (78 vs. 74 minutes, p<0.0001), but lower adjusted risk of bleeding (OR=0.62, 95% CI (0.53, 0.72), p<0.0001) and lower adjusted risk of in–hospital mortality (OR=0.76, 95% CI (0.57, 0.99), p=0.0455).
In this large national database, use TRI in STEMI has increased over the study period. Despite longer door–to–balloon times, TRI was associated with lower risk of bleeding and reduced in–hospital mortality.
West, Room 2001
Monday, March 11, 2013, 8:00 a.m.–8:10 a.m.
Session Title: ST–Elevation Myocardial Infarction and High–Risk PCI
Abstract Category: 40. TCT@ACC–i2: ACS/AMI/Hemodynamic Support
Presentation Number: 2908–1
- 2013 American College of Cardiology Foundation