Sasko Kedev1, Renan Sukmawan2, Oliver Kalpak3, Surya Dharma2, Slobodan Antov3, Jorgo Kostov3, Hristo Pejkov3, Igor Spiroski3. 1. University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia. Electronic address: skedev@gmail.com. 2. Harapan Kita National Cardiovascular Center, Department of Cardiology & Vascular Medicine, University of Indonesia, Jakarta, Indonesia. 3. University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia.
Abstract
BACKGROUND: Female patients possess a higher risk for poorer outcome in ST segment elevation myocardial infarction (STEMI). There is possibility that transradial access (TRA) for primary percutaneous coronary intervention (PPCI) could provide better outcome than transfemoral access (TFA) in female patients with STEMI. METHODS: From 2008 to 2010, 418 female patients (out of 1808 patients) underwent PPCI for acute STEMI. The registry recruited all-comers patients with acute STEMI. Cardiac mortality, major bleeding, and overall MACE rates (composite of death, stroke, re MI and target vessel revascularization-TVR) after 2years follow-up were compared between TRA and TFA. RESULTS: TRA for PPCI was performed in 261 patients and 157 underwent TFA PPCI. The 30-days, 1year mortality and 2year mortality rates were lower in TRA compared to TFA (6.9% vs.14.6%, p=0.012, 8.8% vs. 15.3%, p=0.045, and 9.2% vs. 16.6%, p=0.027respectively). After 2years follow-up, the overall MACE rates were similar (26.4% vs. 31.2%, p=0.336). The overall major bleeding and major vascular access site bleeding were more favorable for TRA than TFA (4.4 vs. 14%, p<0.001, and 2.7 vs. 10.8%, p<0.001, respectively). CONCLUSION: Transradial access for primary PCI in female patients provided better clinical outcomes with lower cardiac mortality and reduced major bleeding in comparison to TFA. There was no significant difference at 2years MACE between TRA and TFA.
BACKGROUND: Female patients possess a higher risk for poorer outcome in ST segment elevation myocardial infarction (STEMI). There is possibility that transradial access (TRA) for primary percutaneous coronary intervention (PPCI) could provide better outcome than transfemoral access (TFA) in female patients with STEMI. METHODS: From 2008 to 2010, 418 female patients (out of 1808 patients) underwent PPCI for acute STEMI. The registry recruited all-comers patients with acute STEMI. Cardiac mortality, major bleeding, and overall MACE rates (composite of death, stroke, re MI and target vessel revascularization-TVR) after 2years follow-up were compared between TRA and TFA. RESULTS:TRA for PPCI was performed in 261 patients and 157 underwent TFA PPCI. The 30-days, 1year mortality and 2year mortality rates were lower in TRA compared to TFA (6.9% vs.14.6%, p=0.012, 8.8% vs. 15.3%, p=0.045, and 9.2% vs. 16.6%, p=0.027respectively). After 2years follow-up, the overall MACE rates were similar (26.4% vs. 31.2%, p=0.336). The overall major bleeding and major vascular access site bleeding were more favorable for TRA than TFA (4.4 vs. 14%, p<0.001, and 2.7 vs. 10.8%, p<0.001, respectively). CONCLUSION: Transradial access for primary PCI in female patients provided better clinical outcomes with lower cardiac mortality and reduced major bleeding in comparison to TFA. There was no significant difference at 2years MACE between TRA and TFA.
Authors: Minke H T Hartman; Jake K B Prins; Remco A J Schurer; Erik Lipsic; Chris P H Lexis; Anouk N A van der Horst-Schrivers; Dirk J van Veldhuisen; Iwan C C van der Horst; Pim van der Harst Journal: Clin Res Cardiol Date: 2017-07-28 Impact factor: 5.460
Authors: Arvindra Krishnamurthy; Claire Keeble; Michelle Anderson; Kathryn Somers; Natalie Burton-Wood; Charlotte Harland; Paul Baxter; Jim McLenachan; Jonathan Blaxill; Daniel J Blackman; Christopher Malkin; Stephen Wheatcroft; John Greenwood Journal: Open Heart Date: 2019-06-29