Key result
The transradial approach for PCI in elderly patients was associated with lower rates of major adverse cardiovascular events at 1 year compared to the transfemoral approach (6.0% vs 13.9%, P=0.019).
Why the study?
Does the transradial approach reduce major adverse cardiovascular events compared to the transfemoral approach in elderly patients undergoing PCI?
Cohort (n=1,098)
Does the transradial approach reduce major adverse cardiovascular events compared to the transfemoral approach in elderly patients undergoing PCI?
The transradial approach for PCI in elderly patients is associated with improved safety and lower rates of major adverse cardiovascular events compared to the transfemoral approach.
Answers are grounded in this paper and cite their sources.
May support radial preference in elderly PCI; observational data leave causality unproven and require RCTs.
The transradial approach (TRA) has been used as access site for percutaneous coronary intervention (PCI) for years. However, no large sample study has evaluated the effect of TRA in elderly patients. A total of 1098 elderly patients (age ≥ 75 years) who underwent PCI by TRA or transfemoral approach were recruited. A 1:1 matched propensity score analysis was performed to minimize bias. The rates of major adverse cardiovascular events that included death, myocardial infarction (MI), and target vessel revascularization during hospitalization (1.3% vs 6.6%, P = .014) and at 1-year follow-up (6.0% vs 13.9%, P = .019) were significantly lower in the TRA group. Transradial approach was also associated with lower rates of in-hospital MI (1.3% vs 5.3%, P = .046), access-site complications (3.3% vs 9.9%, P = .018), and major bleeding (1.3% vs 5.3%, P = .046). In conclusion, TRA showed better safety in elderly patients; it should be considered as a preferred route for elderly patients.
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He et al. (2014) conducted a cohort in Percutaneous coronary intervention (n=1,098). Transradial approach vs. Transfemoral approach was evaluated on Major adverse cardiovascular events (death, myocardial infarction, and target vessel revascularization) at 1-year follow-up (p=.019). The transradial approach for PCI in elderly patients was associated with lower rates of major adverse cardiovascular events at 1 year compared to the transfemoral approach (6.0% vs 13.9%, P=0.019).
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