Radial versus femoral artery access for percutaneous coronary artery intervention in patients with acute myocardial infarction and multivessel disease complicated by cardiogenic shock: Subanalysis from the CULPRIT-SHOCK trial
| Autor: | Suzanne de Waha-Thiele, Paul Guedeney, Jan J. Piek, Ulf Landmesser, Jean-Philippe Collet, Ibrahim Akin, Olivier Barthelemy, Johanne Silvain, Uwe Zeymer, Marie Hauguel-Moreau, Stefan Baumann, Georg Fuernau, Marcus Sandri, Michel Zeitouni, Steffen Desch, Holger Thiele, Stéphanie Rouanet, Benoit Lattuca, Mathieu Kerneis, Stephan Windecker, Gilles Montalescot |
|---|---|
| Přispěvatelé: | Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], University Hospital Leipzig, Medical Faculty [Mannheim], University of Heidelberg, Medical Faculty, VU University Medical Center [Amsterdam], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Bern University Hospital [Berne] (Inselspital), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Leipzig University, University of Mannheim, Heidelberg University, Universität zu Lübeck = University of Lübeck [Lübeck], StatEthic, Amsterdam UMC - Amsterdam University Medical Center, Klinikum Ludwigshafen [Germany], CCSD, Accord Elsevier, Cardiology, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment [SDV]Life Sciences [q-bio] Myocardial Infarction Shock Cardiogenic Kaplan-Meier Estimate 030204 cardiovascular system & hematology Culprit 03 medical and health sciences Percutaneous Coronary Intervention 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine Myocardial infarction Stroke Aged Chi-Square Distribution business.industry Cardiogenic shock Percutaneous coronary intervention Odds ratio Middle Aged medicine.disease 3. Good health Femoral Artery [SDV] Life Sciences [q-bio] Logistic Models Treatment Outcome Radial Artery Conventional PCI Cardiology Myocardial infarction complications Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Heart Journal American Heart Journal, Elsevier, 2020, 225, pp.60-68. ⟨10.1016/j.ahj.2020.04.014⟩ American Heart Journal, 2020, 225, pp.60-68. ⟨10.1016/j.ahj.2020.04.014⟩ American heart journal, 225, 60-68. Mosby Inc. |
| ISSN: | 0002-8703 |
| DOI: | 10.1016/j.ahj.2020.04.014⟩ |
| Popis: | International audience; Background: The use and impact of transradial artery access (TRA) compared to transfemoral artery access (TFA) in patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (MI) complicated by cardiogenic shock (CS) remain unclear.Methods: This is a post hoc analysis of the CULPRIT-SHOCK trial where patients presenting with MI and multivessel disease complicated by CS were randomized to a strategy of culprit-lesion-only or immediate multivessel PCI. Arterial access was left at operator's discretion. Adjudicated outcomes of interest were the composite of death or renal replacement therapy (RRT) at 30 days and 1 year. Multivariate logistic models were used to assess the association between the arterial access and outcomes.Results: Among the 673 analyzed patients, TRA and TFA were successfully performed in 118 (17.5%) and 555 (82.5%) patients, respectively. Compared to TFA, TRA was associated with a lower 30-day rate of death or RRT (37.3% vs 53.2%, adjusted odds ratio [aOR]: 0.57; 95% confidence interval [CI] 0.34-0.96), a lower 30-day rate of death (34.7% vs 49.7%; aOR: 0.56; 95% CI 0.33-0.96), and a lower 30-day rate of RRT (5.9% vs 15.9%; aOR: 0.40; 95% CI 0.16-0.97). No significant differences were observed regarding the 30-day risks of type 3 or 5 Bleeding Academic Research Consortium bleeding and stroke. The observed reduction of death or RRT and death with TRA was no longer significant at 1 year (44.9% vs 57.8%; aOR: 0.85; 95% CI 0.50-1.45 and 42.4% vs 55.5%, aOR: 0.78; 95% CI 0.46-1.32, respectively).Conclusions: In patients undergoing PCI for acute MI complicated by CS, TRA may be associated with improved early outcomes, although the reason for this finding needs further research. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect