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Citation
Tags
HERO ID
7194435
Reference Type
Journal Article
Title
Reduced periprocedural mortality and bleeding rates of radial approach in ST-segment elevation myocardial infarction. Propensity score analysis of data from the ORPKI Polish National Registry
Author(s)
Siudak, Z; Tokarek, T; Dziewierz, A; Wysocki, T; Wiktorowicz, A; Legutko, J; Zmudka, K; Dudek, D; ,
Year
2017
Is Peer Reviewed?
Yes
Journal
EuroIntervention
ISSN:
1774-024X
Publisher
EUROPA EDITION
Location
TOULOUSE CEDEX 6
Page Numbers
843-850
PMID
28606891
Web of Science Id
WOS:000411226400012
Abstract
Aims: We sought to evaluate bleeding complications and periprocedural outcomes of the radial approach (RA) as compared to the femoral approach (FA) during percutaneous coronary intervention (PCI) in "real-world" patients with ST-segment elevation myocardial infarction (STEMI).Methods and results: The study group consisted of 22,812 consecutive patients with STEMI treated with PCI and stent implantation between January 2014 and June 2015 in 151 tertiary invasive cardiology centres in Poland (the ORPKI Polish National Registry). Patients treated using the RA and FA were compared using a propensity score analysis to avoid possible selection bias. The analysis was carried out in an "as-treated" manner. The FA was used in 9,334 (40.9%) and the RA in 13,478 (59.1%) patients. After propensity score matching, a higher total amount of contrast (191.8 +/- 8.0 vs. 174.8 +/- 68.8 ml; p=0.001) and lower radiation doses (1,279.5 +/- 1,346.3 vs. 1,182.6 +/- 887 mGy; p=0.02) were reported in FA. More access-site-related bleeding complications after both angiography (0.17% vs. 0.02%; p=0.004) and PCI (0.23% vs. 0.09%; p=0.049) were reported in the FA group. Periprocedural death (1.94% vs. 0.93%; p=0.001) was more common after PCI performed with the FA.Conclusions: The radial approach was associated with a lower incidence of periprocedural death in STEMI patients as well as a significant reduction of bleeding complications at the access site.
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