Background

Transradial intervention (TRI) is drastically increasing in every intervention society around the world because of lower incidence of major bleeding and vascular complications compared with trans-femoral intervention (TFI). However, there have been limited publications regarding clinical outcomes of TRI versus TFI in ST elevation myocardial infarction (STEMI) patients (pts) of Asian population.

Methods

A total of 689 consecutive STEMI pts from nine major hospitals were enrolled from Jan to Dec 2009. Angiographic outcomes and cumulative clinical outcomes up to 12 months were compared between TRI (n=220, 31.9%) and TFI group (n=469, 28.1%).

Results

Baseline characteristics showed that TRI group had more smokers and a higher incidence of hypertension, diabetes mellitus and previous cerebrovascular accidents whereas TFI group had a higher incidence of multi-vessel disease, left circumflex lesion, type B2 or C lesion and chronic total occlusion. TRI group had a lower incidence of major and minor hemorrhage during admission. Clinical outcomes up to 12 months showed that recurrent myocardial infarction, target lesion revascularization (TLR) and target vessel revascularization (TVR) were lower in the TRI group. Propensity score matched analysis showed that TRI was an independent predictor of reducing TVR (OR: 0.08 95% CI: 0.01-0.67, p Value=0.019), MACE (OR: 0.37, 95% CI: 0.15-0.86, p Value=0.022), and MACCE (OR: 0.33, 95% CI: 0.14-0.76, p Value=0.010) at 12 months.

Conclusion

In our study, TRI in STEMI pts undergoing primary PCI with DES was associated with lower 12-months TVR, MACE and MACCE. We suggest that TRI may play an important role in improving mid-term major clinical outcomes of STEMI pts undergoing PCI with DESs.

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.