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December 1, 2011EuroIntervention

Radial access in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty in acute myocardial infarction: the HORIZONS-AMI trial

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Why the study?

Does a transradial approach reduce adverse clinical events and bleeding compared to a transfemoral approach in patients with STEMI undergoing primary PCI?

Population

3,340 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary…

Comparison

Transradial (TR) approach (n=200) vs Transfemoral (TF) approach (n=3,134)

Design

Cohort

Follow-up

1 year

Key result

Transradial access for primary PCI in STEMI was associated with significantly lower 30-day MACE compared to transfemoral access (2.0% vs. 5.6%; OR 0.35; 95% CI 0.13-0.95; p=0.02).

Authors

PGPhilippe GénéreuxRMRoxana MehranTPTullio Palmerini

Discussion

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Member takes

Overview

May favor transradial access in STEMI primary PCI; leaves open need for randomized confirmation before practice change.

Study Design

Type

Observational (n=3,340)

Structured PICO

Does a transradial approach reduce adverse clinical events and bleeding compared to a transfemoral approach in patients with STEMI undergoing primary PCI?

P
Population
3,340 patients with STEMI undergoing primary PCI with contemporary anticoagulant regimens, evaluated at 30 days and 1 year.
E
Exposure
Transradial (TR) approach (n=200)
C
Comparator
Transfemoral (TF) approach (n=3,134)
O
Outcome
30-day and one-year rates of major adverse cardiovascular events (MACE: death, reinfarction, stroke or target vessel revascularisation), non CABG-related major bleeding, and net adverse clinical events (NACE: MACE or major bleeding)composite

Main Result

Odds Ratio: 0.35 (95% CI 0.13–0.95)

Absolute Event Rate: 2% vs 5.6%

p-value: p=0.02

In patients with STEMI undergoing primary PCI, a transradial approach is associated with reduced major bleeding and improved event-free survival compared to a transfemoral approach.

Limitations

  • post hoc analysis

Cite This Study

Généreux et al. (2011) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=3,340). Transradial (TR) approach vs. Transfemoral (TF) approach was evaluated on 30-day major adverse cardiovascular events (MACE) (OR 0.35, 95% CI 0.13-0.95, p=0.02). Transradial access for primary PCI in STEMI was associated with significantly lower 30-day MACE compared to transfemoral access (2.0% vs. 5.6%; OR 0.35; 95% CI 0.13-0.95; p=0.02).

synapsesocial.com/papers/6a9ef89b5fc198d2b3904f0ahttps://doi.org/10.4244/eijv7i8a144
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