Why the study?
Does radial access compared to femoral access reduce smoking cessation rates in STEMI patients undergoing primary percutaneous coronary intervention?
Cohort (n=138)
Does radial access compared to femoral access reduce smoking cessation rates in STEMI patients undergoing primary percutaneous coronary intervention?
Absolute Event Rate: 41% vs 67%
p-value: p=0.003
Radial access for primary PCI in STEMI patients is associated with a significantly lower smoking cessation rate at one year compared to femoral access, potentially due to a more comfortable recovery that lowers awareness of disease severity.
Radial access was associated with lower smoking cessation; this leaves open any causal effect and should not yet change practice.
Kontext: ZanechĂĄnĂ kouĹenĂ je potenciĂĄlnÄ nejĂşÄinnÄjĹĄĂm opatĹenĂm v rĂĄmci sekundĂĄrnĂ prevence a po akutnĂm infarktu myokardu s elevacemi Ăşseku ST (STEMI) sice zlepĹĄuje prognĂłzu, nicmĂŠnÄ vĂce neĹž polovina pacientĹŻ po STEMI nadĂĄle kouĹĂ. Bylo prokĂĄzĂĄno, Ĺže povÄdomĂ o zĂĄvaĹžnosti onemocnÄnĂ a krĂĄtkodobĂ˝ pobyt v nemocnici po zaĹazujĂcĂm STEMI jsou spojeny s kuĹĂĄctvĂm pĹetrvĂĄvajĂcĂm i po STEMI.CĂl: Zhodnotit paradoxnĂ vztah mezi procenty osob, kterĂŠ zanechaly kouĹenĂ, a skĂłre kvality Ĺživota v souvislosti se zdravĂm (health-related quality of life, QOL) u nemocnĂŠho se STEMI, u nÄhoĹž byla provedena primĂĄrnĂ perkutĂĄnnĂ koronĂĄrnĂ intervence (pPCI) radiĂĄlnĂm (radial access, RA) versus femorĂĄlnĂm pĹĂstupem (femoral access, FA).Metody: Do naĹĄĂ studie bylo zaĹazeno 138 pacientĹŻ se STEMI, u nichĹž byla provedena pPCI s pouĹžitĂm FA nebo RA. Byla stanovena procenta osob, kterĂŠ zanechaly kouĹenĂ, a vypoÄĂtĂĄna skĂłre QOL.VĂ˝sledky: Pacienti ve skupinÄ s RA (46 osob, 57 ± 9 let, 87 % muŞů) mÄli v prvnĂm tĂ˝dnu po pPCI vyĹĄĹĄĂ skĂłre v dotaznĂku European Quality of Life-5 Dimensions (EQ-5D) oproti skupinÄ FA (92 pacientĹŻ, 57 ± 8 let, 75 % muŞů [FA: mediĂĄn 0,81 (0,22) vs. RA: 1 (0,22); p = 0,042]), i kdyĹž pĹi vstupnĂm vyĹĄetĹenĂ byly hodnoty podobnĂŠ (FA: mediĂĄn 1 [0] vs. RA: 1 [0]; p = 0,992). CelkovĂĄ dĂŠlka pobytu v nemocnici (RA: mediĂĄn 3 [1] dny vs. FA: 4 [1]; p < 0,001) byla ve skupinÄ RA vĂ˝znamnÄ kratĹĄĂ. ZatĂmco procento osob, kterĂŠ do jednoho roku po propuĹĄtÄnĂ z nemocnice zanechaly kouĹenĂ, dosĂĄhlo ve skupinÄ RA hodnoty 41 %, ve skupinÄ FA to bylo 67 % (p = 0,003). NezĂĄvislĂ˝mi prediktory pokraÄovĂĄnĂ v kouĹenĂ po STEMI byly ĹženskĂŠ pohlavĂ, doba od nĂĄstupu bolesti do dveĹĂ, a pouĹžitĂ RA bÄhem pPCI.ZĂĄvÄr: Tato studie prokĂĄzala, Ĺže procento osob, kterĂŠ zanechaly kouĹenĂ, je ve skupinÄ RA ve srovnĂĄnĂ se skupinou FA niŞťĂ. VyĹĄĹĄĂ mĂra pohodlĂ pĹi lĂŠÄbÄ STEMI s pouĹžitĂm RA mĹŻĹže bĂ˝t spojena s menĹĄĂm povÄdomĂm o zĂĄvaĹžnosti onemocnÄnĂ a niŞťà motivacĂ k zanechĂĄnĂ kouĹenĂ. Proto je tĹeba se pĹi kaĹždĂŠ nĂĄvĹĄtÄvÄ pacienta u lĂŠkaĹe pacienta dotazovat, zda kouĹĂ, zvlĂĄĹĄtÄ u pacientĹŻ po prodÄlanĂŠ pPCI s pouĹžitĂm radiĂĄlnĂho pĹĂstupu.
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Deveci et al. (2018) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=138). Transradial approach vs. Transfemoral approach was evaluated on Smoking cessation rate at one year after discharge (p=0.003).
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