Document Detail


Radial Versus Femoral Access for Angioplasty of ST-segment Elevation Acute Myocardial Infarction With Second-generation Drug-eluting Stents.
MedLine Citation:
PMID:  25064315     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Invasive and pharmacological treatment of ST-segment elevation acute myocardial infarction reduces the rate of ischemic events but not bleeding complications. The objective of this study was to compare clinical results and bleeding complications between femoral and radial access routes in patients with ST-segment elevation acute myocardial infarction.
METHODS: An evaluation was performed of the population of the Examination study, a randomized, multicenter, clinical trial that included 1498 patients with ST-segment elevation acute myocardial infarction who underwent emergency angioplasty. Subanalysis of this population was conducted to compare patients by type of access (femoral vs radial). The primary end point was a composite of: all-cause death, myocardial infarction, revascularization, and bleeding.
RESULTS: Femoral and radial access routes were used in 825 (55%) and 673 (45%) patients, respectively. More bleeding complications (major and minor) were seen with femoral access than radial access (5.9% vs 2.8%; P<.004), largely due to a greater incidence of minor bleeding with femoral access (4.6% vs 1.9%; P=.005). After adjustment for confounders, survival analysis showed a reduction in the primary composite end point in patients with radial access (hazard ratio=0.73; 95% confidence interval, 0.56-0.96; P=.022).
CONCLUSIONS: In patients with ST-segment elevation acute myocardial infarction, the radial approach is an effective technique that improves prognosis and reduces bleeding complications. Full English text available from: www.revespcardiol.org/en.
Authors:
Vicens Marti; Salvatore Brugaletta; Joan García-Picart; Guillermo Delgado; Angel Cequier; Andrés Iñiguez; Rosana Hernandez-Antolin; Patrick Serruys; Antonio Serra; Manel Sabaté;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-23
Journal Detail:
Title:  Revista espanola de cardiologia     Volume:  -     ISSN:  1579-2242     ISO Abbreviation:  Rev Esp Cardiol     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Sociedad Española de Cardiología. Publicado por Elsevier España. All rights reserved.
Vernacular Title:
Acceso radial frente a femoral en angioplastia por infarto agudo de miocardio con elevación del segmento ST con stent farmacoactivo de segunda generación.
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