PMID- 33220324
OWN - NLM
STAT- MEDLINE
DCOM- 20210315
LR  - 20210315
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 141
DP  - 2021 Feb 15
TI  - Meta-Analysis of Transradial vs Transfemoral Access for Percutaneous Coronary 
      Intervention in Patients With ST Elevation Myocardial Infarction.
PG  - 23-30
LID - S0002-9149(20)31242-X [pii]
LID - 10.1016/j.amjcard.2020.11.016 [doi]
AB  - Transradial access (TRA) has emerged as an alternative to transfemoral access 
      (TFA) for percutaneous coronary intervention (PCI) in ST elevation myocardial 
      infarction (STEMI) patients. However, the rate of TRA adoption has been much 
      slower in the acute coronary syndrome (ACS) patient population. This 
      meta-analysis was conducted to assess clinical outcomes of TRA compared with TFA 
      in STEMI patients undergoing PCI. A manual search of PubMed, EMBASE, Cochrane 
      library database, Cumulative Index to Nursing and Allied Health Literature 
      (CINAHL), ClinicalTrials.gov, and recent major scientific conference sessions 
      from inception to October 15th, 2019 was performed. Primary outcomes in our 
      analysis were all-cause mortality and trial-defined major bleeding. Secondary 
      outcomes included vascular complications, myocardial infarction, stroke, 
      procedure, and fluoroscopy time. 17 randomized controlled trials (RCTs) 
      (N = 12,018) met inclusion criteria. TRA was associated with lower all-cause 
      mortality (risk ratio [RR]: 0.71, 95% confidence interval [CI]: 0.57 to 0.88), 
      major bleeding (RR: 0.59, 95%CI: 0.45 to 0.77), and vascular complications (RR: 
      0.42, 95%CI: 0.32 to 0.56) compared with TFA. There was no difference in the 
      incidence of myocardial infarction (MI), stroke, or procedure duration between 
      the 2 groups. The difference in all-cause mortality between TRA and TFA was 
      statistically nonsignificant when major bleeding was held constant. In 
      conclusion, TRA was associated with lower risk of all-cause mortality, major 
      bleeding, and vascular complications compared with TFA in STEMI patients 
      undergoing PCI.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Jhand, Aravdeep
AU  - Jhand A
AD  - University of Nebraska Medical Center, Omaha, Nebraska.
FAU - Atti, Varunsiri
AU  - Atti V
AD  - Michigan State University, Lansing, Michigan.
FAU - Gwon, Yeongjin
AU  - Gwon Y
AD  - University of Nebraska Medical Center, Omaha, Nebraska.
FAU - Dhawan, Rahul
AU  - Dhawan R
AD  - University of Nebraska Medical Center, Omaha, Nebraska.
FAU - Turagam, Mohit K
AU  - Turagam MK
AD  - The Icahn School of Medicine at Mount Sinai, New York, New York.
FAU - Mamas, Mamas A
AU  - Mamas MA
AD  - Keele Cardiovascular Research Group, Keele University, Keele, UK.
FAU - Brilakis, Emmanouil S
AU  - Brilakis ES
AD  - Minneapolis Heart Institute, Minneapolis, Minnesota.
FAU - Kumar, Arnav
AU  - Kumar A
AD  - Emory University, Atlanta, Georgia.
FAU - Katta, Natraj
AU  - Katta N
AD  - University of Nebraska Medical Center, Omaha, Nebraska.
FAU - Chatzizisis, Yiannis
AU  - Chatzizisis Y
AD  - University of Nebraska Medical Center, Omaha, Nebraska.
FAU - Parikh, Manish
AU  - Parikh M
AD  - Weill Cornell Medicine, Brooklyn, New York.
FAU - Abbott, J Dawn
AU  - Abbott JD
AD  - Brown University, Providence, Rhode Island.
FAU - Kirtane, Ajay J
AU  - Kirtane AJ
AD  - Columbia University Irving Medical Center/New York-Presbyterian Hospital and the 
      Cardiovascular Research Foundation, New York, New York.
FAU - Bhatt, Deepak L
AU  - Bhatt DL
AD  - Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, 
      Boston, Massachusetts.
FAU - Velagapudi, Poonam
AU  - Velagapudi P
AD  - University of Nebraska Medical Center, Omaha, Nebraska. Electronic address: 
      poonamchou@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20201118
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Femoral Artery/*surgery
MH  - Humans
MH  - Mortality
MH  - Percutaneous Coronary Intervention/*methods
MH  - Postoperative Complications/epidemiology
MH  - Postoperative Hemorrhage/*epidemiology
MH  - Punctures/*methods
MH  - Radial Artery/*surgery
MH  - ST Elevation Myocardial Infarction/*surgery
COIS- Declaration of Interests The authors declare that they have no known competing 
      financial interests or personal relationships that could have appeared to 
      influence the work reported in this paper.
EDAT- 2020/11/22 06:00
MHDA- 2021/03/16 06:00
CRDT- 2020/11/21 20:07
PHST- 2020/09/14 00:00 [received]
PHST- 2020/11/02 00:00 [revised]
PHST- 2020/11/03 00:00 [accepted]
PHST- 2020/11/22 06:00 [pubmed]
PHST- 2021/03/16 06:00 [medline]
PHST- 2020/11/21 20:07 [entrez]
AID - S0002-9149(20)31242-X [pii]
AID - 10.1016/j.amjcard.2020.11.016 [doi]
PST - ppublish
SO  - Am J Cardiol. 2021 Feb 15;141:23-30. doi: 10.1016/j.amjcard.2020.11.016. Epub 
      2020 Nov 18.