Lingxia Xu , Wei Lu , Ganwei Shi , Wenhua Li , Jianqiang Xiao , Anni Yang , Feng Li , Gaojun Cai
{"title":"经桡动脉远端入路和传统经桡动脉入路经皮冠状动脉介入治疗急性冠状动脉综合征的长期预后比较","authors":"Lingxia Xu , Wei Lu , Ganwei Shi , Wenhua Li , Jianqiang Xiao , Anni Yang , Feng Li , Gaojun Cai","doi":"10.1016/j.hjc.2024.03.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Distal transradial access (dTRA) has recently emerged as a new vascular access alternative for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). However, published data on long-term mortality and major adverse cardiac events after PCI via dTRA are inconclusive. The aim of this study was to compare the long-term prognoses of PCI via dTRA and conventional transradial access (cTRA) for acute coronary syndrome (ACS) after 1–3 years of follow-up.</div></div><div><h3>Methods</h3><div>Patients who were diagnosed with ACS and underwent PCI between January 1, 2020 and December 31, 2021, were retrospectively enrolled. The patients were divided into two groups at a 1:1 ratio, subjected to propensity score matching (PSM), and then followed for 1–3 years after PCI. Cox proportional hazards regression was used to evaluate the relationship between the two access sites and clinical outcomes.</div></div><div><h3>Results</h3><div>Among the 550 patients in the dTRA and cTRA groups, 11 (4.0%) and 19 (6.9%) died during the observation period, respectively. dTRA and cTRA had similar risks of all-cause mortality [hazard ratio (HR) = 0.688; 95% CI = 0.323–1.463; <em>P</em> = 0.331] and major adverse cardiac events (MACEs, HR = 0.806, 95% CI = 0.515–1.263; <em>P</em> = 0.347) after PCI. The risk of cardiovascular mortality (HR = 0.330, 95% CI = 0.107–1.105; <em>P</em> = 0.053), TLR-MACEs (HR = 0.587, 95% CI = 0.339–1.109; <em>P</em> = 0.058), and unplanned revascularization (HR = 0.860, 95% CI = 0.483–1.529; <em>P</em> = 0.606) were not significantly different between the two groups.</div></div><div><h3>Conclusions</h3><div>PCI via dTRA has the same long-term prognoses as PCI via cTRA in ACS patients, and the compression time and bleeding rate are lower than those in patients undergoing PCI via cTRA.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 28-37"},"PeriodicalIF":2.7000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of long-term prognoses of percutaneous coronary intervention via distal transradial and conventional transradial access for acute coronary syndrome\",\"authors\":\"Lingxia Xu , Wei Lu , Ganwei Shi , Wenhua Li , Jianqiang Xiao , Anni Yang , Feng Li , Gaojun Cai\",\"doi\":\"10.1016/j.hjc.2024.03.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Distal transradial access (dTRA) has recently emerged as a new vascular access alternative for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). However, published data on long-term mortality and major adverse cardiac events after PCI via dTRA are inconclusive. The aim of this study was to compare the long-term prognoses of PCI via dTRA and conventional transradial access (cTRA) for acute coronary syndrome (ACS) after 1–3 years of follow-up.</div></div><div><h3>Methods</h3><div>Patients who were diagnosed with ACS and underwent PCI between January 1, 2020 and December 31, 2021, were retrospectively enrolled. The patients were divided into two groups at a 1:1 ratio, subjected to propensity score matching (PSM), and then followed for 1–3 years after PCI. Cox proportional hazards regression was used to evaluate the relationship between the two access sites and clinical outcomes.</div></div><div><h3>Results</h3><div>Among the 550 patients in the dTRA and cTRA groups, 11 (4.0%) and 19 (6.9%) died during the observation period, respectively. dTRA and cTRA had similar risks of all-cause mortality [hazard ratio (HR) = 0.688; 95% CI = 0.323–1.463; <em>P</em> = 0.331] and major adverse cardiac events (MACEs, HR = 0.806, 95% CI = 0.515–1.263; <em>P</em> = 0.347) after PCI. The risk of cardiovascular mortality (HR = 0.330, 95% CI = 0.107–1.105; <em>P</em> = 0.053), TLR-MACEs (HR = 0.587, 95% CI = 0.339–1.109; <em>P</em> = 0.058), and unplanned revascularization (HR = 0.860, 95% CI = 0.483–1.529; <em>P</em> = 0.606) were not significantly different between the two groups.</div></div><div><h3>Conclusions</h3><div>PCI via dTRA has the same long-term prognoses as PCI via cTRA in ACS patients, and the compression time and bleeding rate are lower than those in patients undergoing PCI via cTRA.</div></div>\",\"PeriodicalId\":55062,\"journal\":{\"name\":\"Hellenic Journal of Cardiology\",\"volume\":\"83 \",\"pages\":\"Pages 28-37\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Hellenic Journal of Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1109966624000563\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hellenic Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1109966624000563","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Comparison of long-term prognoses of percutaneous coronary intervention via distal transradial and conventional transradial access for acute coronary syndrome
Background
Distal transradial access (dTRA) has recently emerged as a new vascular access alternative for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). However, published data on long-term mortality and major adverse cardiac events after PCI via dTRA are inconclusive. The aim of this study was to compare the long-term prognoses of PCI via dTRA and conventional transradial access (cTRA) for acute coronary syndrome (ACS) after 1–3 years of follow-up.
Methods
Patients who were diagnosed with ACS and underwent PCI between January 1, 2020 and December 31, 2021, were retrospectively enrolled. The patients were divided into two groups at a 1:1 ratio, subjected to propensity score matching (PSM), and then followed for 1–3 years after PCI. Cox proportional hazards regression was used to evaluate the relationship between the two access sites and clinical outcomes.
Results
Among the 550 patients in the dTRA and cTRA groups, 11 (4.0%) and 19 (6.9%) died during the observation period, respectively. dTRA and cTRA had similar risks of all-cause mortality [hazard ratio (HR) = 0.688; 95% CI = 0.323–1.463; P = 0.331] and major adverse cardiac events (MACEs, HR = 0.806, 95% CI = 0.515–1.263; P = 0.347) after PCI. The risk of cardiovascular mortality (HR = 0.330, 95% CI = 0.107–1.105; P = 0.053), TLR-MACEs (HR = 0.587, 95% CI = 0.339–1.109; P = 0.058), and unplanned revascularization (HR = 0.860, 95% CI = 0.483–1.529; P = 0.606) were not significantly different between the two groups.
Conclusions
PCI via dTRA has the same long-term prognoses as PCI via cTRA in ACS patients, and the compression time and bleeding rate are lower than those in patients undergoing PCI via cTRA.
期刊介绍:
The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments.
Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.