Key result
Transradial approach for primary PCI in STEMI patients provided similar door-to-balloon times to the transfemoral approach (70 vs 72 minutes; P>0.27) and fewer access site complications.
Why the study?
Does a transradial approach compared to a transfemoral approach improve door-to-balloon times and access site complications in STEMI patients undergoing primary PCI?
Cohort (n=316)
Does a transradial approach compared to a transfemoral approach improve door-to-balloon times and access site complications in STEMI patients undergoing primary PCI?
Absolute Event Rate: 70% vs 72%
p-value: p=> 0.27
Transradial access for primary PCI in STEMI does not delay door-to-balloon times compared to transfemoral access and significantly reduces access site complications.
Transradial access yields similar door-to-balloon times; leaves open whether benefits extend to unselected STEMI populations.
OBJECTIVES: The objective of this study was to compare door-to-balloon times and other variables in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) using transfemoral or transradial approaches. BACKGROUND: Transradial PCI has been shown to lower the risk of access site complications but the procedure is not applied to STEMI patients, due to concerns of procedural complexity adversely affecting prompt reperfusion. There is paucity of real-world data comparing TRI with TFI in patients with STEMI. METHODS: Three hundred sixteen consecutive patients with STEMI undergoing primary PCI were studied. Patients were divided in two groups, Group I (n = 204) undergoing PCI transfemorally and Group II (n = 109) patients transradially. Demographic data, door-to-balloon times, procedural variables, predischarge adverse events, access site complications, and 1 year follow-up major adverse cardiac events (MACE) were recorded. RESULTS: Door-to-balloon time was 72 +/- 14 min in Group I compared with 70 +/- 17 min in Group II, the difference was not statistically significant (t = 1.096, P > 0.27). Group II patients had significantly fewer access site complications compared with Group I (20 vs. 1 patient, chi(2) = 10.8, P < 0.05). Demographics, predischarge adverse events, and MACE at 1 year follow-up were comparable between the two groups. CONCLUSIONS: Transradial approach to primary PCI provides similar door-to-balloon times to transfemoral approach, and significantly lowers access site related complications, in patients presenting with STEMI.
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Pancholy et al. (2010) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=316). Transradial approach vs. Transfemoral approach was evaluated on Door-to-balloon time (p=> 0.27). Transradial approach for primary PCI in STEMI patients provided similar door-to-balloon times to the transfemoral approach (70 vs 72 minutes; P>0.27) and fewer access site complications.
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