Comparison of transradial and transfemoral coronary intervention in octogenarians with acute myocardial infarction
| Autor: | Jung Cheon Choi, Myung Ho Jeong, Kwang Soo Cha, Hye Yoon Jang, Youngkeun Ahn, Jong Hyun Choi, Shung Chull Chae, Jun-Hyok Oh, Young Jo Kim, Hye Won Lee, Jinhee Ahn, Jung Hyun Choi, Han Cheol Lee, Taek Jong Hong, Eun-Young Yun |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction 030204 cardiovascular system & hematology Revascularization Killip Class III 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Internal medicine Angioplasty Republic of Korea medicine Humans 030212 general & internal medicine Myocardial infarction Hospital Mortality Angioplasty Balloon Coronary Propensity Score Aged 80 and over business.industry Incidence Age Factors Percutaneous coronary intervention medicine.disease Femoral Artery Treatment Outcome Conventional PCI Cohort Radial Artery Cardiology Female Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | International journal of cardiology. 202 |
| ISSN: | 1874-1754 |
| Popis: | Background The transradial (TR) approach for percutaneous coronary intervention (PCI) is challenging and associated with failure in elderly patients. We compared the TR and transfemoral (TF) approaches in patients >80years with acute myocardial infarction (MI) undergoing PCI. Methods A total of 1945 (7.2%) octogenarians were enrolled from among 27,129 patients in the Korea Acute Myocardial Infarction Registry. The TR group (n=336, 17.3%) was compared with the TF group (n=1609, 82.7%) in the overall and propensity-matched cohorts with respect to procedural success, complications, in-hospital mortality, and one-year mortality and total major adverse cardiac event (MACE; death, MI, and revascularization) rate. Results In the overall cohort, the TR group had lower incidence of Killip class III or IV compared to the TF group. The disease extent and lesion severity were similar between groups, as was the procedural success rate (97.7% vs. 98.3%); however, in-hospital complications were significantly lower in the TR group (8.1% vs. 20.3%). In-hospital mortality was significantly lower in the TR group than the TF group (3.4% vs. 11.4%), as were the one-year mortality and total MACE (9.8% vs. 18.4% and 13% vs. 21.9%, respectively). These outcomes were consistent in the propensity-matched cohort. The TR approach was found to be a significant predictor of low in-hospital mortality (OR 0.355, 95% CI 0.139–0.907), but not of one-year mortality (OR 0.644, 95% CI 0.334–1.240). Conclusions In octogenarians with acute MI undergoing PCI, the TR approach was more effective than the TF approach as it had lower complication rate and better clinical outcomes with comparable procedural success. |
| Databáze: | OpenAIRE |
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