Reference : Influence of access site selection on PCI-related adverse events in patients with STE...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/10993/18377
Influence of access site selection on PCI-related adverse events in patients with STEMI: meta-analysis of randomised controlled trials.
English
Mamas, Mamas A. [> >]
Ratib, Karim [> >]
Routledge, Helen [> >]
Fath-Ordoubadi, Farzin [> >]
Neyses, Ludwig mailto [University of Luxembourg > Research Office]
Louvard, Yves [> >]
Fraser, Douglas G. [> >]
Nolan, Jim [> >]
6-Dec-2012
Heart (British Cardiac Society)
98
4
303-11
Yes (verified by ORBilu)
International
1355-6037
1468-201X
England
[en] Angioplasty, Balloon, Coronary/adverse effects/methods ; Femoral Artery ; Hemorrhage/epidemiology/etiology ; Humans ; Incidence ; Myocardial Infarction/therapy ; Radial Artery ; Randomized Controlled Trials as Topic ; Risk Factors ; Survival Rate ; United States/epidemiology
[en] OBJECTIVE: A meta-analysis of all randomised controlled studies that compare outcomes of transradial versus the transfemoral route to better define best practice in patients with ST elevation myocardial infarction (STEMI). DESIGN: A Medline and Embase search was conducted using the search terms 'transradial,' 'radial', 'STEMI', 'myocardial' and 'infarction'. SETTING: Randomised controlled studies that compare outcomes of transradial versus the transfemoral route. PATIENTS: A total of nine studies were identified that consisted of 2977 patients with STEMI. Interventions Studies that compare outcomes of transradial versus the transfemoral route. MAIN OUTCOME MEASURES: The primary clinical outcomes of interest were (1) mortality; (2) major adverse cardiac events (MACE); (3) major bleeding and (4) access site complications. RESULTS: Transradial PCI was associated with a reduction in mortality (OR 0.53, 95% CI 0.33 to 0.84; p=0.008), MACE (OR 0.62, 95% CI 0.43 to 0.90; p=0.012), major bleeding events (OR 0.63, 95% CI 0.35-1.12; p=0.12) and access site complications (OR 0.30, 95% CI 0.19 to 0.48; p<0.0001) compared with procedures performed through the femoral route. CONCLUSIONS: This meta-analysis demonstrates a significant reduction in mortality, MACE and major access site complications associated with the transradial access site in STEMI. The meta-analysis supports the preferential use of radial access for STEMI PCI.
http://hdl.handle.net/10993/18377
10.1136/heartjnl-2011-300558
http://heart.bmj.com/content/98/4/303.full.pdf+html

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