" Studies evaluating the efficacy and safety of the transradial approach for percutaneous coronary intervention (PCI) were carried out mainly before the widespread use of stents and glycoprotein (GP) IIb/IIIa inhibitors. We sought to determine the association between the choice of the vascular access site and procedural complications after PCI performed with routine stenting and GP IIb/IIIa inhibition," scientists in Toronto, Canada report (see also Cardiology).
" The data source was a prospective registry of 13,499 consecutive cases of PCI at the University Health Network, Toronto, Canada, from April 2000 to September 2006. Logistic regression was used to calculate the probability of selection to the radial access group. Using propensity score methodology, 3,198 patients with femoral access were randomly matched to 3,198 patients with radial access based on clinical, angiographic, and procedural characteristics. Multivariable logistic regression analysis was used to identify the independent predictors of access site-related complications. Major adverse cardiac event was defined as death, myocardial infarction, abrupt vessel closure, or coronary artery bypass surgery. Use of the transradial approach was associated with fewer vascular access complications (1.5% vs 0.6%, P< .001) and a shorter length of hospital stay. Multivariable analysis revealed transradial access (OR 0.39, 95% CI 0.2-0.7) to be an independent predictor of lower risk, whereas primary PCI (OR 4.36, 95% CI 1.4, 13), recent myocardial infarction (OR 2.0 95% CI 1.2, 3.4), age (per 10 years increase: OR 1.37, 95% CI 1.1-1.7) and female gender (OR 2.78 95% CI 1.7, 4.6) were independent predictors of a higher risk of access site complications," wrote J. Eichhoefer and colleagues.
The researchers concluded: " Use of transradial access for PCI is safe and is independently associated with a reduced rate of in-hospital access site complications and reduced length of hospital stay. (Am Heart J 2008; 156:864-70.)'."
Eichhoefer and colleagues published their study in American Heart Journal (Decreased complication rates using the transradial compared to the transfemoral approach in percutaneous coronary intervention in the era of routine stenting and glycoprotein platelet IIb/IIIa inhibitor use: A large single-center experience. American Heart Journal, 2008;156(5):864-870).
For more information, contact V. Dzavik, Toronto General Hospital, University of Health Network, Peter Munk Cardiac Center, Intervent Cardiology Program, EN 12-224A, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada.
Publisher contact information for the American Heart Journal is: Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.
Keywords: Canada, Toronto, Life Sciences, Cardiology, Coronary Artery Bypass, Heart Bypass Surgery, Heart Disease, Coronary Artery Disease.
This article was prepared by Cardiovascular Week editors from staff and other reports. Copyright 2008, Cardiovascular Week via NewsRx.com.
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