Autor: |
Jay Shavadia, Robert Welsh, Anthony Gershlick, Yinggan Zheng, Kurt Huber, Sigrun Halvorsen, Phillipe G. Steg, Frans Van de Werf, Paul W. Armstrong |
Jazyk: |
angličtina |
Rok vydání: |
2016 |
Předmět: |
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Zdroj: |
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 5, Iss 6 (2016) |
Druh dokumentu: |
article |
ISSN: |
2047-9980 |
DOI: |
10.1161/JAHA.116.003559 |
Popis: |
BackgroundThe effectiveness of radial access (RA) in ST‐elevation myocardial infarction (STEMI) has been predominantly established in primary percutaneous coronary intervention (pPCI) with limited exploration of this issue in the early postfibrinolytic patient. The purpose of this study was to compare the effectiveness and safety of RA versus femoral (FA) access in STEMI undergoing either a pharmacoinvasive (PI) strategy or pPCI. Methods and ResultsWithin STrategic Reperfusion Early After Myocardial Infarction (STREAM), we evaluated the relationship between arterial access site and primary outcome (30‐day composite of death, shock, congestive heart failure, or reinfarction) and major bleeding according to the treatment strategy received. A total of 1820 STEMI patients were included: 895 PI (49.2%; rescue PCI [n=379; 42.3%], scheduled PCI [n=516; 57.7%]) and 925 pPCI (50.8%). Irrespective of treatment strategy, there was comparable utilization of either access site (FA: PI 53.4% and pPCI 57.6%). FA STEMI patients were younger, had lower presenting systolic blood pressure, lesser Thrombolysis In Myocardial Infarction risk, and more ∑ST‐elevation at baseline. The primary composite endpoint occurred in 8.9% RA versus 15.7% FA patients (P |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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