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SHR Neuro Cancer Cardio Lipid Metab Microb

Komócsi, A; Aradi, D; Kehl, D; Ungi, I; Thury, A; Pintér, T; Di, Nicolantonio, JJ; Tornyos, A; Vorobcsuk, A.
Meta-analysis of randomized trials on access site selection for percutaneous coronary intervention in ST-segment elevation myocardial infarction.
Arch Med Sci. 2014; 10(2): 203-12. Doi: 10.5114/aoms.2014.42570 [OPEN ACCESS]
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Co-authors Med Uni Graz: Tornyos Adrienn
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Abstract:: INTRODUCTION: Superior outcomes with transradial (TRPCI) versus transfemoral coronary intervention (TFPCI) in the setting of acute ST-segment elevation myocardial infarction (STEMI) have been suggested by earlier studies. However, this effect was not evident in randomized controlled trials (RCTs), suggesting a possible allocation bias in observational studies. Since important studies with heterogeneous results regarding mortality have been published recently, we aimed to perform an updated review and meta-analysis on the safety and efficacy of TRPCI compared to TFPCI in the setting of STEMI. MATERIAL AND METHODS: Electronic databases were searched for relevant studies from January 1993 to November 2012. Outcome parameters of RCTs were pooled with the DerSimonian-Laird random-effects model. RESULTS: Twelve RCTs involving 5,124 patients were identified. According to the pooled analysis, TRPCI was associated with a significant reduction in major bleeding (odds ratio (OR): 0.52 (95% confidence interval (CI) 0.38-0.71, p < 0.0001)). The risk of mortality and major adverse events was significantly lower after TRPCI (OR = 0.58 (95% CI: 0.43-0.79), p = 0.0005 and OR = 0.67 (95% CI: 0.52-0.86), p = 0.002 respectively). CONCLUSIONS: Robust data from randomized clinical studies indicate that TRPCI reduces both ischemic and bleeding complications in STEMI. These findings support the preferential use of radial access for primary PCI.
Find related publications in this database (Keywords): ST-segment elevation myocardial infarction; transradial; transfemoral; death