Transradial primary PCI in elderly AMI patients yielded fewer vascular access site complications (1.8% vs 13.1%, P<0.05) and similar 1-month MACE (5.3% vs 6.5%, P>0.05) compared to transfemoral PCI.
Cohort (n=103)
Does the transradial approach improve safety and feasibility compared to the transfemoral approach for primary PCI in elderly patients with acute myocardial infarction?
The transradial approach for primary PCI in elderly AMI patients significantly reduces vascular access site complications and hospital length of stay compared to the transfemoral approach, without compromising procedural success or increasing short-term MACE.
Absolute Event Rate: 5.3% vs 6.5%
p-value: p=> 0.05
BACKGROUND: Transradial coronary intervention has been widely used because of its effects in lowering the incidence of complications in vascular access site and improving patient satisfaction compared to the femoral approach. This study aimed to investigate the safety and feasibility of transradial approach for primary percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI). METHODS: A total of 103 consecutive elderly patients (age = 65 years) who were diagnosed as having AMI were indicated for PCI. Among them, 57 patients received primary PCI via the transradial approach (transradial intervention, TRI group), and 46 underwent primary PCI via the transfemoral approach (transfemoral intervention, TFI group). The success rate of puncture, puncture time, cannulation time, reperfusion time, the total time for PCI, the success rate of PCI, the use rates of temporary pacemaker and intra-aortic balloon pump (IABP), and the total length of hospital stay of the patients in the two groups were compared. After the procedure, vascular access site complications and major adverse cardiovascular events (MACE) in the two groups in one month were observed. RESULTS: The success rates of puncture (98.2% vs 100.0%) and PCI (96.5% vs 95.7%) for the patients in the TRI and TFI groups were not statistically significant (P > 0.05). The puncture time ((2.4 +/- 1.1) vs (2.0 +/- 0.9) minutes), cannulation time ((2.7 +/- 0.5) vs (2.6 +/- 0.5) minutes), reperfusion time ((16.2 +/- 4.5) vs (15.4 +/- 3.6) minutes), total time of the procedure ((44.1 +/- 6.8) vs (41.2 +/- 5.7) minutes), use rates of temporary pacemaker (1.8% vs 2.2%) and IABP (0 vs 2.2%) in the two groups were not statistically significant (P > 0.05), but the hospital stay of the TFI group was longer than that of the TRI group ((10.1 +/- 4.6) vs (7.2 +/- 2.6) days, P 0.05). CONCLUSION: The transradial approach for primary PCI is safe and feasible for elderly patients with AMI.
Yan et al. (2008) conducted a cohort in Acute myocardial infarction (AMI) (n=103). Transradial approach for primary PCI vs. Transfemoral approach for primary PCI was evaluated on Major adverse cardiovascular events (MACE) at one month (p=> 0.05). Transradial primary PCI in elderly AMI patients yielded fewer vascular access site complications (1.8% vs 13.1%, P<0.05) and similar 1-month MACE (5.3% vs 6.5%, P>0.05) compared to transfemoral PCI.
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