PMID- 32105411 OWN - NLM STAT- MEDLINE DCOM- 20210202 LR - 20210202 IS - 1522-726X (Electronic) IS - 1522-1946 (Print) IS - 1522-1946 (Linking) VI - 96 IP - 2 DP - 2020 Aug TI - Association of adoption of transradial access for percutaneous coronary intervention in ST elevation myocardial infarction with door-to-balloon time. PG - E165-E173 LID - 10.1002/ccd.28785 [doi] AB - OBJECTIVES: We aimed to study adoption of transradial primary percutaneous coronary intervention (TR-PPCI) for ST elevation myocardial infarction (STEMI) ("radial first" approach) and its association with door-to-balloon time (D2BT). BACKGROUND: TR-PPCI for STEMI is underutilized in the United States due to concerns about prolonging D2BT. Whether operators and hospitals adopting a radial first approach in STEMI incur prolonged D2BT is unknown. METHODS: In 1,272 consecutive cases of STEMI with PPCI at our hospital from January 1, 2011, to December 31, 2016, we studied TR-PPCI adoption and its association with D2BT including a propensity matched analysis of similar risk TR-PPCI and trans-femoral primary PCI (TF-PPCI) patients. RESULTS: With major increases in hospital-level TR-PPCI (hospital TR-PPCI rate: 2.6% in 2011 to 79.4% in 2016, p-trend<.001) and operator-level TR-PPCI (mean operator TR-PPCI rate: 2.9% in 2011 to 81.1% in 2016, p-trend = .005), median hospital level D2BT decreased from 102 min [81, 142] in 2011 to 84 min [60, 105] in 2016 (p-trend<.001). TF crossover (10.3%; n = 57) was not associated with unadjusted D2BT (TR-PPCI success 91 min [72, 112] vs. TF crossover 99 min [70, 115], p = .432) or D2BT adjusted for study year and presenting location (7.2% longer D2BT with TF crossover, 95% CI: -4.0% to +18.5%, p = .208). Among 273 propensity-matched pairs, unadjusted D2BT (TR-PPCI 98 [78, 117] min vs. TF-PPCI 101 [76, 132] min, p = .304), and D2BT adjusted for study year and presenting location (5.0% shorter D2BT with TR-PPCI, 95% CI: -12.4% to +2.4%, p = .188) were similar. CONCLUSIONS: TR-PPCI can be successfully implemented without compromising D2BT performance. CI - (c) 2020 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc. FAU - Huded, Chetan P AU - Huded CP AUID- ORCID: 0000-0003-0151-5471 AD - Heart and Vascular Institute Center for Healthcare Delivery Innovation, Cleveland Clinic, Cleveland, Ohio. AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Kapadia, Samir R AU - Kapadia SR AUID- ORCID: 0000-0002-0026-3391 AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Ballout, Jad A AU - Ballout JA AD - Medicine Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Krishnaswamy, Amar AU - Krishnaswamy A AUID- ORCID: 0000-0001-6048-7955 AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Ellis, Stephen G AU - Ellis SG AUID- ORCID: 0000-0001-6239-9772 AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Raymond, Russell AU - Raymond R AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Cho, Leslie AU - Cho L AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Simpfendorfer, Conrad AU - Simpfendorfer C AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Bajzer, Chris AU - Bajzer C AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Martin, Joseph AU - Martin J AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Nair, Ravi AU - Nair R AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Lincoff, A Michael AU - Lincoff AM AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Kravitz, Kathleen AU - Kravitz K AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Menon, Venu AU - Menon V AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Hantz, Scott AU - Hantz S AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. FAU - Khot, Umesh N AU - Khot UN AD - Heart and Vascular Institute Center for Healthcare Delivery Innovation, Cleveland Clinic, Cleveland, Ohio. AD - Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. LA - eng PT - Comparative Study PT - Journal Article PT - Observational Study DEP - 20200227 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 - *Catheterization, Peripheral/adverse effects MH - Female MH - *Femoral Artery MH - Humans MH - Male MH - Middle Aged MH - *Percutaneous Coronary Intervention/adverse effects MH - Punctures MH - *Radial Artery MH - Registries MH - Risk Assessment MH - Risk Factors MH - ST Elevation Myocardial Infarction/diagnostic imaging/*therapy MH - Time Factors MH - *Time-to-Treatment MH - Treatment Outcome PMC - PMC7496393 OTO - NOTNLM OT - cardiac catheterization OT - myocardial infarct OT - percutaneous transluminal coronary angioplasty OT - radial artery OT - reperfusion COIS- Stephen Ellis has served as a consultant for Abbott Vascular, Boston Scientific, and Medtronic. Umesh Khot has served as a consultant for AstraZeneca. The remaining authors have no conflicts of interest to disclose. Michael Lincoff has served as a consultant for Novo Nordisk, Akcea, and Novatis and has received research funding for his institution from AbbVie, AstraZeneca, CSL Behring, Eli Lilly, and Pfizer. EDAT- 2020/02/28 06:00 MHDA- 2021/02/03 06:00 PMCR- 2020/09/17 CRDT- 2020/02/28 06:00 PHST- 2019/09/26 00:00 [received] PHST- 2019/12/14 00:00 [revised] PHST- 2020/02/10 00:00 [accepted] PHST- 2020/02/28 06:00 [pubmed] PHST- 2021/02/03 06:00 [medline] PHST- 2020/02/28 06:00 [entrez] PHST- 2020/09/17 00:00 [pmc-release] AID - CCD28785 [pii] AID - 10.1002/ccd.28785 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2020 Aug;96(2):E165-E173. doi: 10.1002/ccd.28785. Epub 2020 Feb 27.