The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Transradial versus transfemoral intervention in ST-segment elevation myocardial infarction patients in Korean population

  • Li, Hu (Department of Cardiovascular, The Second Affiliated Hospital of Kunming Medical University) ;
  • Rha, Seung-Woon (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Choi, Byoung Geol (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Shim, Min Suk (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Choi, Se Yeon (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Choi, Cheol Ung (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Kim, Eung Ju (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Oh, Dong Joo (Department of Medicine, Graduate School, Korea University College of Medicine) ;
  • Cho, Byung Ryul (Department of Cardiology, Kangwon National University Hospital) ;
  • Kim, Moo Hyun (Cardiovascular Center, Dong-A University Hospital) ;
  • Kim, Doo-Il (Cardiovascular Center, Inje University Busan Paik Hospital) ;
  • Jeong, Myung-Ho (Cardiovascular Center, Chonnam National University Hospital) ;
  • Yoo, Sang Yong (Cardiovascular Center, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Jeong, Sang-Sik (Cardiovascular Center, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Kim, Byung Ok (Cardiovascular Center, Inje University Sanggye Paik Hospital) ;
  • Hyun, Min Su (Cardiovascular Center, Soonchunhyang University Seoul Hospital) ;
  • Youn, Young-Jin (Cardiovascular Center, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine) ;
  • Yoon, Junghan (Cardiovascular Center, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine)
  • Received : 2016.09.30
  • Accepted : 2017.01.09
  • Published : 2018.07.01
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Abstract

Background/Aims: Transradial intervention (TRI) is becoming the preferred method over transfemoral intervention (TFI) because TRI is associated with lower incidence of major bleeding and vascular complications. However, there has been limited published data regarding the clinical outcomes of TRI versus TFI in Korean patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 689 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs) from January to December of 2009 at nine university hospitals were enrolled in this study. Mid-term angiographic and 12-month cumulative clinical outcomes of the TRI group (n = 220, 31.9%) were compared to those of the TFI group (n = 469, 28.1%). Results: After propensity score matching, in-hospital complications and the 12-month major clinical outcomes during follow-up in the two groups were similar to each other. However, the incidence rates of repeat revascularization (6.4% vs. 0.5%, p = 0.003), target vessel revascularization (6.4% vs. 0.5%, p = 0.003), and major adverse cardiac events (MACE; 11.6% vs. 4.6%, p = 0.018) in the TFI group were higher than those in the TRI group during the 12-month of follow-up. Conclusions: In our study, TRI in STEMI patients undergoing primary PCI with DESs was associated with lower incidence of access site hematoma, 12-month repeat revascularization, and MACE compared to TFI. Therefore, TRI might play an important role in reducing bleeding complications while improving major clinical outcomes in STEMI patients undergoing primary PCI with DESs.

Keywords

References

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