Document Detail


Influence of access site selection on PCI-related adverse events in patients with STEMI: meta-analysis of randomised controlled trials.
MedLine Citation:
PMID:  22147900     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ObjectiveA meta-analysis of all randomised controlled studies that compare outcomes of transradial versus the transfemoral route to better define best practice in patients with ST elevation myocardial infarction (STEMI).DesignA Medline and Embase search was conducted using the search terms 'transradial,' 'radial', 'STEMI', 'myocardial' and 'infarction'.SettingRandomised controlled studies that compare outcomes of transradial versus the transfemoral route.PatientsA total of nine studies were identified that consisted of 2977 patients with STEMI.InterventionsStudies that compare outcomes of transradial versus the transfemoral route.Main outcome measuresThe primary clinical outcomes of interest were (1) mortality; (2) major adverse cardiac events (MACE); (3) major bleeding and (4) access site complications.ResultsTransradial PCI was associated with a reduction in mortality (OR=0.52, 95% CI 0.33 to 0.83; p=0.006), MACE (OR=0.62, 95% CI 0.43 to 0.90; p=0.012), major bleeding events (OR=0.55, 95% CI 0.31 to 0.99; p=0.049) and access site complications (OR=0.30, 95% CI 0.19 to 0.48; p<0.0001) compared with procedures performed through the femoral route.ConclusionsThis meta-analysis demonstrates a significant reduction in mortality, MACE, major bleeding events and major access site complications associated with the transradial access site in STEMI. The meta-analysis supports the preferential use of radial access for STEMI PCI.
Authors:
Mamas A Mamas; Karim Ratib; Helen Routledge; Farzin Fath-Ordoubadi; Ludwig Neyses; Yves Louvard; Douglas G Fraser; Jim Nolan
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-6
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  -     ISSN:  1468-201X     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Manchester Royal Infirmary, Biomedical Research Centre, Manchester, UK.
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