Predictors and outcomes associated with radial versus femoral access for intervention in patients with acute coronary syndrome in a real-world setting: Results from the Acute Coronary Syndrome Israeli Survey (ACSIS) 2010

Paul Fefer, Shlomi Matetzky, Sharon Gannot, Shmuel Gottlieb, David Meerkin, Liudmila Bubyr, Natalie Gavrielov, Doron Zahger, Ilan Goldenberg, Ran Kornowski, Amit Segev

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND: Use of transradial intervention (TRI) is becoming more popular, and recent studies suggest an advantage for TRI in high-risk patients presenting with acute coronary syndrome (ACS). The aim of our study was to describe current utilization and outcomes of transradial intervention (TRI) in real-world patients presenting with ACS. METHODS: Data were derived from the ACS Israeli Survey (ACSIS 2010), a nationwide prospective survey of patients presenting with ACS over a 2-month period. Follow-up was continued for up to 1 year. RESULTS: Of 1815 ACS patients undergoing coronary angiography, 613 (34%) underwent TRI, which was more likely to be employed among patients with lower-risk characteristics. Patients undergoing TRI had significantly lower 30-day mortality and in-hospital bleeding. On multivariate analysis, the risk of in-hospital major bleeding was reduced by 60% in patients undergoing TRI (P≤.04). However, no significant differences in other components of major adverse cardiac events or mortality were demonstrated at 30 days. All-cause mortality at 1 year was significantly lower among patients who underwent TRI. However, after multivariate adjustment, this effect was no longer significant. CONCLUSIONS: In our study of real-world patients, better TRI outcomes are related largely to lower baseline risk of patients allocated to this approach, suggesting that TRI may be underutilized in high-risk ACS patients.

Original languageEnglish
Pages (from-to)398-402
Number of pages5
JournalJournal of Invasive Cardiology
Volume26
Issue number8
StatePublished - 1 Jan 2014
Externally publishedYes

Keywords

  • PCI
  • acute coronary syndrome
  • radial approach

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