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Transradial approach in myocardial infarction.
MedLine Citation:
PMID:  21591584     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: This study investigates the feasibility, efficacy, and safety of routine primary percutaneous coronary intervention via transradial approach in patients with acute ST-elevation myocardial infarction.
METHODS AND RESULTS: From 2005 to 2007,122 consecutive patients with acute ST-elevation myocardial infarction within 12 hours, including those experiencing cardiogenic shock, were eligible for primary transradial PCI if the radial artery pulse could be felt. Efficacy, safety, and major adverse cardiac events regarding mortality, recurrent non-fatal myocardial infarction, and revascularization were recorded. Eighty-five of 122 patients underwent transradial PCI, and 37 had transfemoral PCI. Older women, haemodynamic instability, and the presence of severe chronic kidney disease (stages 4 and 5) or end-stage renal disease were significantly related to choice of transfemoral approach (P < 0.05). Glycoprotein IIb/IIIa inhibitors were used more often in patients who underwent transradial PCI than in those who underwent transfemoral PCI (37% vs 16%; P = 0.043). The incidence of major bleeding complications requiring blood transfusion was significantly higher in the transfemoral group (P = 0.004). A similar procedural success rate was achieved in both groups (P = 0.737). During follow-up of 580 days, the total major adverse cardiac events were similar in both groups (P = 0.299).
CONCLUSIONS: Routine transradial primary PCI can be safely and successfully performed on up to 70% of acute ST-elevation myocardial infarction patients and, compared with transfemoral approach, is associated with a significantly reduced rate of major bleeding complications.
Authors:
Hsu-Lung Jen; Wei-Hsian Yin; Kuan-Chun Chen; An-Ning Feng; Shih-Ping Ma; Chin-Feng Cheng; Mason Shing Young
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  66     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-05-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  239-45     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Internal Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC.
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