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Transradial Versus Transfemoral Coronary Intervention for Acute Myocardial Infarction Complicated by Cardiogenic Shock: Is Transradial Coronary Intervention Suitable for Emergency PCI in High-Risk Acute Myocardial Infarction?
MedLine Citation:
PMID:  24791717     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to compare the clinical results of TRI and transfemoral coronary intervention (TFI) in AMI patients who had cardiogenic shock and underwent emergency percutaneous coronary intervention (PCI).
METHODS: Between January 1, 2006, and August 31, 2012, a total of 507 consecutive patients with AMI underwent emergency PCI within 12 hours of onset. Eighty-five patients presented with cardiogenic shock and were enrolled. Among these patients, 60 underwent TRI and 25 underwent TFI. Outcome measures included the following: major bleeding and vascular complications; major adverse cardiac or cerebrovascular events (MACCE); all-cause death; door-to-balloon time; and PCI procedural success.
RESULTS: TRI had a significantly lower rate of major bleeding and vascular complications within 30 days (6.7% vs 28.0%; P<.05) and 1 year (log-rank P<.05) than TFI. No significant differences were observed between the two groups in the MACCE rate within 30 days (28.3% vs 44.0%; P=.21) and 1 year (log-rank P=.06), and the all-cause death rate within 30 days (26.7% vs 40.0%; P=.30) and 1 year (log-rank P=.09). In addition, TRI was not inferior to TFI in terms of door-to-balloon time (99.8 min vs 110.4 min; P=.30) and PCI procedural success (95.0% vs 96.0%; P>.99).
CONCLUSION: TRI is associated with fewer major bleeding and vascular complications than TFI, and it appears suitable for both low- and high-risk AMI patients, especially when AMI is complicated by cardiogenic shock.
Authors:
Atsushi Iga; Kenji Wagatsuma; Junichi Yamazaki; Takanori Ikeda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  26     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-05-05     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  196-202     Citation Subset:  IM    
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