Objectives
The transradial approach (TRA) has been increasingly employed as an alternative approach to percutaneous coronary intervention (PCI). We aimed to investigate the impact of a TRA compared with a transfemoral approach (TFA) on 1 and 6 months clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI.
Methods
315 patients who underwent primary PCI for STEMI were evaluated retrospectively. TRA consisted of 55 (19 females, mean-age 55±10 years), and TFA 76 patients (21 females, mean-age 53±9 years). Endpoints included the 30-day and six-month rates of major adverse cardiovascular events (MACE: death, reinfarction, target lesion revascularisation and stroke) and net adverse clinical events (NACE: MACE and bleeding).
Results
Two groups were similar in terms of baseline clinical characteristics. Arterial cannulation, door-to-balloon and total procedure times, and access-site crossover rates were not significantly differ between TRA and TFA (p=0.914, p=0.162, p=0.422, and p=0.197; respectively). While infarction localizations and the vessel numbers treated were similar in two groups, the use of tirofiban was higher (p=0.034) and hospital stay was lower (p=0.020) in TRA. The 30-day rate of MACE was lower in TRA than in TFA, but not statically significant (p=0.127). TRA compared to TFA was associated with significantly lower 30-day rates of NACE (p=0.007). At six months, the TRA had significantly reduced rates of MACE (p=0.019) and NACE (p=0.001).
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