PMID- 22147900
OWN - NLM
STAT- MEDLINE
DCOM- 20120306
LR  - 20201216
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 98
IP  - 4
DP  - 2012 Feb
TI  - Influence of access site selection on PCI-related adverse events in patients with 
      STEMI: meta-analysis of randomised controlled trials.
PG  - 303-11
LID - 10.1136/heartjnl-2011-300558 [doi]
AB  - 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.
FAU - Mamas, Mamas A
AU  - Mamas MA
AD  - Clinical Lecturer in Cardiology, Manchester Heart Centre, Manchester Royal 
      Infirmary, Manchester M13 9PT, UK. mamasmamas1@yahoo.co.uk
FAU - Ratib, Karim
AU  - Ratib K
FAU - Routledge, Helen
AU  - Routledge H
FAU - Fath-Ordoubadi, Farzin
AU  - Fath-Ordoubadi F
FAU - Neyses, Ludwig
AU  - Neyses L
FAU - Louvard, Yves
AU  - Louvard Y
FAU - Fraser, Douglas G
AU  - Fraser DG
FAU - Nolan, Jim
AU  - Nolan J
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20111206
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2012 Feb;98(4):269-70. PMID: 22147901
CIN - Nat Rev Cardiol. 2012 Feb;9(2):66. PMID: 22231717
MH  - Angioplasty, Balloon, Coronary/*adverse effects/methods
MH  - Femoral Artery
MH  - Hemorrhage/*epidemiology/etiology
MH  - Humans
MH  - Incidence
MH  - Myocardial Infarction/*therapy
MH  - Radial Artery
MH  - *Randomized Controlled Trials as Topic
MH  - Risk Factors
MH  - Survival Rate
MH  - United States/epidemiology
EDAT- 2011/12/08 06:00
MHDA- 2012/03/07 06:00
CRDT- 2011/12/08 06:00
PHST- 2011/12/08 06:00 [entrez]
PHST- 2011/12/08 06:00 [pubmed]
PHST- 2012/03/07 06:00 [medline]
AID - heartjnl-2011-300558 [pii]
AID - 10.1136/heartjnl-2011-300558 [doi]
PST - ppublish
SO  - Heart. 2012 Feb;98(4):303-11. doi: 10.1136/heartjnl-2011-300558. Epub 2011 Dec 6.