Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | International Journal of Cardiovascular Sciences (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000600562 |
Resumo: | Abstract Background: In coronary procedures, although the radial approach protects patients from hemorrhagic complications, it is technically more complex than the femoral approach. Objectives: To test the hypothesis that the radial approach is the procedure of choice in ACS patients due to the high risk of bleeding; and to identify independent predictors of the choice for radial access. Methods: Patients admitted for ACS who underwent invasive coronary procedure were included. We registered the type of access (femoral or radial) chosen by the physician for the first angiography; the investigators did not interfere with this choosing process. Student’s t-test was used for comparisons between the CRUSADE and ACUITY scores. Predictors of radial access were compared between the groups. Statistical significance was defined by p < 0,05. Results: Radial access was chosen in 67% of 347 consecutive patients. Patients who underwent radial approach had lower risk of bleeding determined by CRUSADE (30 ± 14 vs. 37 ± 15; p < 0.001) as compared with femoral access. In multivariate analysis, four variables were identified as independent predictors negatively associated with radial access - age (OR = 0.98; 95%CI = 0.96 - 0.99), creatinine (OR = 0.54; 95%CI = 0.3 - 0.98), signs of left ventricular failure (OR = 0.45; 95% CI = 0.22 - 0.92) and previous CABG (OR = 0.022; 95%CI = 0.003 - 0.166). Conclusion: The propensity to choose radial over femoral access in coronary intervention was not primarily influenced by patients’ bleeding risk. Predictors of this decision, identified in the study, indicated less complex patients, suggesting that the difficulty in performing the technique was a stronger determinant than its potential antihemorrhagic effect. (Int J Cardiovasc Sci. 2018; [online].ahead print, PP.0-0) |
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International Journal of Cardiovascular Sciences (Online) |
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Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment ParadoxAngioplastyCatheterismCoronary Artery DiseasePercutaneous Coronary InterventionRadial ArteryFemoral ArteryStentsAbstract Background: In coronary procedures, although the radial approach protects patients from hemorrhagic complications, it is technically more complex than the femoral approach. Objectives: To test the hypothesis that the radial approach is the procedure of choice in ACS patients due to the high risk of bleeding; and to identify independent predictors of the choice for radial access. Methods: Patients admitted for ACS who underwent invasive coronary procedure were included. We registered the type of access (femoral or radial) chosen by the physician for the first angiography; the investigators did not interfere with this choosing process. Student’s t-test was used for comparisons between the CRUSADE and ACUITY scores. Predictors of radial access were compared between the groups. Statistical significance was defined by p < 0,05. Results: Radial access was chosen in 67% of 347 consecutive patients. Patients who underwent radial approach had lower risk of bleeding determined by CRUSADE (30 ± 14 vs. 37 ± 15; p < 0.001) as compared with femoral access. In multivariate analysis, four variables were identified as independent predictors negatively associated with radial access - age (OR = 0.98; 95%CI = 0.96 - 0.99), creatinine (OR = 0.54; 95%CI = 0.3 - 0.98), signs of left ventricular failure (OR = 0.45; 95% CI = 0.22 - 0.92) and previous CABG (OR = 0.022; 95%CI = 0.003 - 0.166). Conclusion: The propensity to choose radial over femoral access in coronary intervention was not primarily influenced by patients’ bleeding risk. Predictors of this decision, identified in the study, indicated less complex patients, suggesting that the difficulty in performing the technique was a stronger determinant than its potential antihemorrhagic effect. (Int J Cardiovasc Sci. 2018; [online].ahead print, PP.0-0)Sociedade Brasileira de Cardiologia2018-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000600562International Journal of Cardiovascular Sciences v.31 n.6 2018reponame:International Journal of Cardiovascular Sciences (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/2359-4802.20180066info:eu-repo/semantics/openAccessLacerda,Yasmin FalconSá,Nicole Cruz deSuerdieck,Jessica GonzalezFonseca,LetíciaLopes,FernandaSodré,Gabriella Sant'AnaViana,Mateus dos SantosRabelo,Marcia Maria NoyaCorreia,Luis Claudio Lemoseng2018-11-13T00:00:00Zoai:scielo:S2359-56472018000600562Revistahttp://publicacoes.cardiol.br/portal/ijcshttps://old.scielo.br/oai/scielo-oai.phptailanerodrigues@cardiol.br||revistaijcs@cardiol.br2359-56472359-4802opendoar:2018-11-13T00:00International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC)false |
dc.title.none.fl_str_mv |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
title |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
spellingShingle |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox Lacerda,Yasmin Falcon Angioplasty Catheterism Coronary Artery Disease Percutaneous Coronary Intervention Radial Artery Femoral Artery Stents |
title_short |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
title_full |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
title_fullStr |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
title_full_unstemmed |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
title_sort |
Option for the Radial versus Femoral Access in Coronary Intervention in Acute Coronary Syndromes: A Risk-Treatment Paradox |
author |
Lacerda,Yasmin Falcon |
author_facet |
Lacerda,Yasmin Falcon Sá,Nicole Cruz de Suerdieck,Jessica Gonzalez Fonseca,Letícia Lopes,Fernanda Sodré,Gabriella Sant'Ana Viana,Mateus dos Santos Rabelo,Marcia Maria Noya Correia,Luis Claudio Lemos |
author_role |
author |
author2 |
Sá,Nicole Cruz de Suerdieck,Jessica Gonzalez Fonseca,Letícia Lopes,Fernanda Sodré,Gabriella Sant'Ana Viana,Mateus dos Santos Rabelo,Marcia Maria Noya Correia,Luis Claudio Lemos |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Lacerda,Yasmin Falcon Sá,Nicole Cruz de Suerdieck,Jessica Gonzalez Fonseca,Letícia Lopes,Fernanda Sodré,Gabriella Sant'Ana Viana,Mateus dos Santos Rabelo,Marcia Maria Noya Correia,Luis Claudio Lemos |
dc.subject.por.fl_str_mv |
Angioplasty Catheterism Coronary Artery Disease Percutaneous Coronary Intervention Radial Artery Femoral Artery Stents |
topic |
Angioplasty Catheterism Coronary Artery Disease Percutaneous Coronary Intervention Radial Artery Femoral Artery Stents |
description |
Abstract Background: In coronary procedures, although the radial approach protects patients from hemorrhagic complications, it is technically more complex than the femoral approach. Objectives: To test the hypothesis that the radial approach is the procedure of choice in ACS patients due to the high risk of bleeding; and to identify independent predictors of the choice for radial access. Methods: Patients admitted for ACS who underwent invasive coronary procedure were included. We registered the type of access (femoral or radial) chosen by the physician for the first angiography; the investigators did not interfere with this choosing process. Student’s t-test was used for comparisons between the CRUSADE and ACUITY scores. Predictors of radial access were compared between the groups. Statistical significance was defined by p < 0,05. Results: Radial access was chosen in 67% of 347 consecutive patients. Patients who underwent radial approach had lower risk of bleeding determined by CRUSADE (30 ± 14 vs. 37 ± 15; p < 0.001) as compared with femoral access. In multivariate analysis, four variables were identified as independent predictors negatively associated with radial access - age (OR = 0.98; 95%CI = 0.96 - 0.99), creatinine (OR = 0.54; 95%CI = 0.3 - 0.98), signs of left ventricular failure (OR = 0.45; 95% CI = 0.22 - 0.92) and previous CABG (OR = 0.022; 95%CI = 0.003 - 0.166). Conclusion: The propensity to choose radial over femoral access in coronary intervention was not primarily influenced by patients’ bleeding risk. Predictors of this decision, identified in the study, indicated less complex patients, suggesting that the difficulty in performing the technique was a stronger determinant than its potential antihemorrhagic effect. (Int J Cardiovasc Sci. 2018; [online].ahead print, PP.0-0) |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000600562 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2359-56472018000600562 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/2359-4802.20180066 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cardiologia |
dc.source.none.fl_str_mv |
International Journal of Cardiovascular Sciences v.31 n.6 2018 reponame:International Journal of Cardiovascular Sciences (Online) instname:Sociedade Brasileira de Cardiologia (SBC) instacron:SBC |
instname_str |
Sociedade Brasileira de Cardiologia (SBC) |
instacron_str |
SBC |
institution |
SBC |
reponame_str |
International Journal of Cardiovascular Sciences (Online) |
collection |
International Journal of Cardiovascular Sciences (Online) |
repository.name.fl_str_mv |
International Journal of Cardiovascular Sciences (Online) - Sociedade Brasileira de Cardiologia (SBC) |
repository.mail.fl_str_mv |
tailanerodrigues@cardiol.br||revistaijcs@cardiol.br |
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1754732625326505984 |