PMID- 32855068
OWN - NLM
STAT- MEDLINE
DCOM- 20210531
LR  - 20210531
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 30
IP  - 1
DP  - 2021 Jan
TI  - Sex Differences in Radial Access for Percutaneous Coronary Intervention in Acute 
      Coronary Syndrome Are Independent of Body Size.
PG  - 108-114
LID - S1443-9506(20)30402-9 [pii]
LID - 10.1016/j.hlc.2020.06.023 [doi]
AB  - BACKGROUND: Radial access reduces bleeding and is associated with improved 
      survival following percutaneous coronary intervention (PCI) for acute coronary 
      syndrome (ACS). We evaluated the association between sex, markers of body size 
      and radial access, and its impact on bleeding and mortality following PCI for 
      ACS. METHODS AND RESULTS: From 2013-2016, consecutive patients treated with PCI 
      for ACS across 30 centres were prospectively entered into the Victorian Cardiac 
      Outcomes Registry and followed for 30 days. Multivariate logistic regression was 
      used to analyse predictors of the primary endpoint of PCI access site and 
      secondary endpoints of major bleeding and mortality. A total of 16,330 ACS 
      patients (40.9% ST elevation myocardial infarction [STEMI]) underwent PCI (23.5% 
      female). Women were older with significantly lower weight and height compared to 
      men. Women had lower radial access use (41.6% versus 51.0%, p<0.001), with higher 
      30-day major bleeding (2.4% versus 1.4%, p<0.001) and mortality (4.4% versus 
      3.4%, p<0.001) than men. Female sex independently predicted lower radial access 
      use (OR 0.75, 95% CI 0.68-0.83, p<0.001) while body surface area, height and body 
      mass index did not. Female sex was an independent predictor of higher 30-day 
      major bleeding (OR 1.38, 95% CI 1.05-1.81, p=0.019) and mortality in STEMI 
      patients (OR 1.31, 95% CI 1.01-1.70. p=0.039). Radial access was associated with 
      lower major bleeding (OR 0.70, 95% CI 0.53-0.91, p=0.009) and mortality (OR 0.60, 
      95% CI 0.48-0.75, p<0.001). CONCLUSIONS: Radial access, despite being associated 
      with lower bleeding and mortality, was used less frequently in women, independent 
      of co-morbidities and objective markers of body size.
CI  - Crown Copyright (c) 2020. Published by Elsevier B.V. All rights reserved.
FAU - Stehli, Julia
AU  - Stehli J
AD  - Cardiology Department, The Alfred Hospital, Melbourne, Vic, Australia; Faculty of 
      Medicine Nursing and Health Sciences, Monash University, Melbourne, Vic, 
      Australia.
FAU - Duffy, Stephen J
AU  - Duffy SJ
AD  - Cardiology Department, The Alfred Hospital, Melbourne, Vic, Australia; Faculty of 
      Medicine Nursing and Health Sciences, Monash University, Melbourne, Vic, 
      Australia.
FAU - Koh, Youlin
AU  - Koh Y
AD  - Cardiology Department, The Alfred Hospital, Melbourne, Vic, Australia.
FAU - Martin, Catherine
AU  - Martin C
AD  - Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, 
      Vic, Australia.
FAU - Brennan, Angela
AU  - Brennan A
AD  - Centre of Cardiovascular Research and Education in Therapeutics, Monash 
      University, Melbourne, Vic, Australia.
FAU - Dinh, Diem T
AU  - Dinh DT
AD  - Centre of Cardiovascular Research and Education in Therapeutics, Monash 
      University, Melbourne, Vic, Australia.
FAU - Lefkovits, Jeffrey
AU  - Lefkovits J
AD  - Centre of Cardiovascular Research and Education in Therapeutics, Monash 
      University, Melbourne, Vic, Australia; Cardiology Department, Royal Melbourne 
      Hospital, Melbourne, Vic, Australia.
FAU - Zaman, Sarah
AU  - Zaman S
AD  - Monash Cardiovascular Research Centre, Monash University, Melbourne, Vic, 
      Australia; Monash Heart, Monash Medical Centre, Melbourne, Vic, Australia; 
      Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, 
      Vic, Australia. Electronic address: sarah.zaman@monash.edu.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200824
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Acute Coronary Syndrome/mortality/*surgery
MH  - Aged
MH  - Catheterization, Peripheral/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Percutaneous Coronary Intervention/*methods
MH  - *Propensity Score
MH  - Prospective Studies
MH  - Radial Artery
MH  - *Registries
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Survival Rate/trends
MH  - Treatment Outcome
MH  - Victoria/epidemiology
OTO - NOTNLM
OT  - BSA
OT  - Major bleeding
OT  - Radial access
OT  - Sex discrepancies
EDAT- 2020/08/29 06:00
MHDA- 2021/06/01 06:00
CRDT- 2020/08/29 06:00
PHST- 2020/01/28 00:00 [received]
PHST- 2020/05/22 00:00 [revised]
PHST- 2020/06/27 00:00 [accepted]
PHST- 2020/08/29 06:00 [pubmed]
PHST- 2021/06/01 06:00 [medline]
PHST- 2020/08/29 06:00 [entrez]
AID - S1443-9506(20)30402-9 [pii]
AID - 10.1016/j.hlc.2020.06.023 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2021 Jan;30(1):108-114. doi: 10.1016/j.hlc.2020.06.023. Epub 
      2020 Aug 24.