PMID- 25945803
OWN - NLM
STAT- MEDLINE
DCOM- 20160609
LR  - 20201216
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 86 Suppl 1
DP  - 2015 Oct
TI  - Use and outcome of radial versus femoral approach for primary PCI in patients 
      with acute ST elevation myocardial infarction without cardiogenic shock: results 
      from the ALKK PCI registry.
PG  - S8-14
LID - 10.1002/ccd.25987 [doi]
AB  - OBJECTIVES: This study sought to compare the use and outcome of radial versus 
      femoral access in patients treated with primary percutaneous coronary 
      intervention (PCI) for acute ST elevation myocardial infarction (STEMI) in 
      clinical practice. BACKGROUND: The radial approach for PCI in patients with STEMI 
      has been suggested to have a lower rate of complications and bleeding and to 
      improve prognosis compared with the femoral approach. However, there still is a 
      large regional and national variation in its use. METHODS: Between 2008 and 2012 
      a total of 17,865 patients with STEMI without cardiogenic shock undergoing 
      primary PCI were prospectively enrolled in the observational German PCI registry 
      of the Arbeitsgemeinschaft leitende kardiologische Krankenhausarzte (ALKK). 
      Transfemoral (TF) access was used in 15,270 (85.5%), transradial (TR) access in 
      2,530 (14.2%), and other access in 65 (0.3%) patients. In this analysis, 10,264 
      patients from 20 centers that had performed at least 5 TR-PCI for STEMI were 
      included. This study compared TR-PCI (n = 2,454 23.9%) with TF-PCI (n = 7,810, 
      76.1%). RESULTS: Procedural success was high in both cohorts. Hospital mortality 
      (1.8 vs. 5.1%, P < 0.001) and vascular access complications (0.3 vs. 1.8%, 
      P < 0.001%) were lower in the TR group. In the multivariate analysis radial 
      access was associated with an improved in-hospital survival rate (OR 0.47, 95% CI 
      0.35-0.65). CONCLUSIONS: The radial approach for PCI can be performed with 
      excellent procedural success in selected STEMI patients and is associated with a 
      lower rate of vascular access complications and hospital mortality.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Bauer, Timm
AU  - Bauer T
AD  - Herzzentrum Ludwigshafen, Institut Fur Herzinfarktforschung Ludwigshafen, 
      Germany.
AD  - Universitatsklinik Giessen, Germany.
FAU - Hochadel, Matthias
AU  - Hochadel M
AD  - Herzzentrum Ludwigshafen, Institut Fur Herzinfarktforschung Ludwigshafen, 
      Germany.
FAU - Brachmann, Johannes
AU  - Brachmann J
AD  - Klinikum Coburg, Germany.
FAU - Schachinger, Volker
AU  - Schachinger V
AD  - Klinikum Fulda, Germany.
FAU - Boekstegers, Peter
AU  - Boekstegers P
AD  - Helios-Klinikum Siegburg, Germany.
FAU - Zrenner, Bernhard
AU  - Zrenner B
AD  - Krankenhaus Landshut-Achdorf, Germany.
FAU - Zahn, Ralf
AU  - Zahn R
AD  - Herzzentrum Ludwigshafen, Institut Fur Herzinfarktforschung Ludwigshafen, 
      Germany.
FAU - Zeymer, Uwe
AU  - Zeymer U
AD  - Herzzentrum Ludwigshafen, Institut Fur Herzinfarktforschung Ludwigshafen, 
      Germany.
CN  - Arbeitsgemeinschaft leitende kardiologische Krankenhausarzte (ALKK)
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20150506
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - Aged
MH  - Cardiac Catheterization/*methods
MH  - *Electrocardiography
MH  - Female
MH  - Femoral Artery
MH  - Follow-Up Studies
MH  - Germany/epidemiology
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnosis/mortality/*surgery
MH  - Percutaneous Coronary Intervention/*methods
MH  - Radial Artery
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Shock, Cardiogenic
MH  - Survival Rate/trends
MH  - Treatment Outcome
OTO - NOTNLM
OT  - ST elevation myocardial infarction
OT  - acute myocardial infarction
OT  - catheterization
OT  - coronary artery disease
OT  - primary percutaneous coronary intervention
OT  - radial access
OT  - registry
EDAT- 2015/05/07 06:00
MHDA- 2016/06/10 06:00
CRDT- 2015/05/07 06:00
PHST- 2014/06/14 00:00 [received]
PHST- 2015/03/25 00:00 [revised]
PHST- 2015/04/04 00:00 [accepted]
PHST- 2015/05/07 06:00 [entrez]
PHST- 2015/05/07 06:00 [pubmed]
PHST- 2016/06/10 06:00 [medline]
AID - 10.1002/ccd.25987 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2015 Oct;86 Suppl 1:S8-14. doi: 10.1002/ccd.25987. 
      Epub 2015 May 6.