Article (Scientific journals)
Influence of access site selection on PCI-related adverse events in patients with STEMI: meta-analysis of randomised controlled trials.
Mamas, Mamas A.; Ratib, Karim; Routledge, Helen et al.
2012In Heart, 98 (4), p. 303-11
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Keywords :
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
Abstract :
[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.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Mamas, Mamas A.
Ratib, Karim
Routledge, Helen
Fath-Ordoubadi, Farzin
Neyses, Ludwig ;  University of Luxembourg > Research Office
Louvard, Yves
Fraser, Douglas G.
Nolan, Jim
Language :
English
Title :
Influence of access site selection on PCI-related adverse events in patients with STEMI: meta-analysis of randomised controlled trials.
Publication date :
06 December 2012
Journal title :
Heart
ISSN :
1468-201X
Publisher :
BMJ Publishing Group, United Kingdom
Volume :
98
Issue :
4
Pages :
303-11
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBilu :
since 16 October 2014

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