The rise of transradial artery access for percutaneous coronary intervention in patients with acute coronary syndromes in Australia

dc.contributor.authorOcsan, Ryan James
dc.contributor.authorDoost, Ata
dc.contributor.authorMarley, Paul
dc.contributor.authorFarshid, Ahmad
dc.date.accessioned2023-10-23T03:02:57Z
dc.date.available2023-10-23T03:02:57Z
dc.date.issued2020
dc.date.updated2022-08-21T08:16:23Z
dc.description.abstractObjectives. The aim of this study was to evaluate the outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) via transradial artery access (TRA) or transfemoral artery access (TFA). Background. Over the last decade, evidence for the benefit of TRA for PCI has grown, leading to a steady uptake of TRA around the world. Despite this, the topic remains controversial with contrary evidence to suggest no significant benefit over TFA. Methods. A retrospective study of consecutive ACS patients from 2011 to 2017 who underwent PCI via TRA or TFA. The primary outcome was Major Adverse Cardiovascular Events (MACE), a composite of death, myocardial infarction (MI), target lesion revascularisation (TLR), or coronary artery bypass graft surgery (CABG) at 12 months. Secondary outcomes included Bleeding Academic Research Consortium (BARC) bleeding events scored 2 or higher, haematoma formation, and stent thrombosis, in addition to all individual components of MACE. Results. We treated 3624 patients (77% male), with PCI via TFA (n = 2391) or TRA (n = 1233). Transradial artery access was associated with a reduction in mortality (3% vs 6.3%; ), MI (1.8% vs 3.9%; ), CABG (0.6% vs 1.5%; ), TLR (1% vs 2.9%; ), large haematoma (0.4% vs 1.8%; ), BARC 2 (0.2% vs 1.1%; ), and BARC 3 events (0.4% vs 1.0%; ). On multivariate Cox regression analysis, TFA, age ≥ 75, prior PCI, use of bare metal stents, cardiogenic shock, cardiac arrest, and multivessel coronary artery disease were associated with an increased risk of MACE. Conclusion. Despite the limitations secondary to the observational nature of our study and multiple confounders, our results are in line with results of major trials and, as such, we feel that our results support the use of TRA as the preferred access site in patients undergoing PCI for ACS to improve patient outcomes.en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn0896-4327en_AU
dc.identifier.urihttp://hdl.handle.net/1885/303466
dc.language.isoen_AUen_AU
dc.provenanceThis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_AU
dc.publisherBlackwell Publishing Inc.en_AU
dc.rights© 2020 The authorsen_AU
dc.rights.licenseCreative Commons Attribution licenceen_AU
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_AU
dc.sourceJournal of Interventional Cardiologyen_AU
dc.titleThe rise of transradial artery access for percutaneous coronary intervention in patients with acute coronary syndromes in Australiaen_AU
dc.typeJournal articleen_AU
dcterms.accessRightsOpen Accessen_AU
local.bibliographicCitation.lastpage8en_AU
local.bibliographicCitation.startpage1en_AU
local.contributor.affiliationOcsan, Ryan, College of Health and Medicine, ANUen_AU
local.contributor.affiliationDoost, Ata, College of Health and Medicine, ANUen_AU
local.contributor.affiliationMarley, Paul, Cardiology Uniten_AU
local.contributor.affiliationFarshid, Ahmad, Non-ANU institution, The Canberra Hospitalen_AU
local.contributor.authoremailu5983325@anu.edu.auen_AU
local.contributor.authoruidOcsan, Ryan, u5983325en_AU
local.contributor.authoruidDoost, Ata, u6004586en_AU
local.contributor.authoruidFarshid, Ahmad, u5683887en_AU
local.description.notesImported from ARIESen_AU
local.identifier.absfor320101 - Cardiology (incl. cardiovascular diseases)en_AU
local.identifier.ariespublicationa383154xPUB16676en_AU
local.identifier.citationvolume2020en_AU
local.identifier.doi10.1155/2020/4397697en_AU
local.identifier.scopusID2-s2.0-85098252570
local.identifier.thomsonIDWOS:000598330600001
local.identifier.uidSubmittedBya383154en_AU
local.publisher.urlhttps://www.hindawi.com/en_AU
local.type.statusPublished Versionen_AU

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