Key result
Transradial access for PCI was independently associated with decreased 30-day mortality compared to transfemoral access across all age groups (e.g., OR 0.64; 95% CI 0.54-0.74, P<0.0001 for age <60).
Why the study?
Does transradial access compared to transfemoral access reduce 30-day mortality across different age groups in patients undergoing PCI?
Cohort (n=469,983)
Yes
Does transradial access compared to transfemoral access reduce 30-day mortality across different age groups in patients undergoing PCI?
Answers are grounded in this paper and cite their sources.
Transradial access for PCI is associated with reduced 30-day mortality across all age groups, yet its adoption remains lowest in older patients who could similarly benefit.
We investigate adoption of the TRA in different age groups and study the relationship between age and access site related outcomes in a national cohort of patients undergoing PCI in the UK. Previous studies have reported conflicting data on radial access site adoption between different age groups, with age an independent predictor of failure of procedures undertaken through the radial approach. Age and access site related outcomes (based on transradial (TRA) and transfemoral (TFA) access) were studied in 469,983 PCI procedures undertaken in the UK from 2006 to 2012 in the age groups; <60, 60-<70, 70-<80, and ≥80 in the British Cardiovascular Intervention Society database. We studied access site practice in 469,983 patients who underwent PCI procedures in the United Kingdom. TRA utilization increased from 17.5% to 65.6% in the age group <60, and 16.6% to 54.5% in the age group ≥80 between 2006 and 2012. TRA was independently associated with decreased 30-day mortality in all age groups (<60: OR 0.64; 95% CI 0.54-0.74, P < 0.0001; 60-<70: OR 0.65; 95% CI 0.57-75, P < 0.0001, 70-<80: OR 0.58 (0.52-0.65, P < 0.0001 and ≥80: OR 0.65 (0.57-0.73, P < 0.0001). Adoption of the TRA for PCI has occurred least in older patients in the UK despite similar associations between TRA use and decreased 30-day mortality observed in all age groups.
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Anderson et al. (2015) conducted a cohort in Percutaneous coronary intervention (n=469,983). Transradial access vs. Transfemoral access was evaluated on 30-day mortality (OR 0.64, 95% CI 0.54-0.74, p=<0.0001). Transradial access for PCI was independently associated with decreased 30-day mortality compared to transfemoral access across all age groups (e.g., OR 0.64; 95% CI 0.54-0.74, P<0.0001 for age <60).
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