Affiliation:
1. Cardiac Medical Unit Grantham Hospital Hong Kong SAR, China
2. Department of Adult Intensive Care Queen Mary Hospital Hong Kong SAR, China
3. Division of Respiratory and Critical Care Medicine Department of Medicine Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong SAR, China
4. Department of Medicine Queen Mary HospitalThe University of Hong Kong Hong Kong SAR, China
Abstract
Background
Percutaneous coronary intervention with radial arterial access has been associated with fewer occurrences of major bleeding. However, published data on the long‐term mortality and major adverse cardiac events after percutaneous coronary intervention with radial or femoral arterial access are inconclusive.
Method and Results
This was a territory‐wide retrospective cohort study including 26 022 patients who underwent first‐ever percutaneous coronary intervention between January 1, 2010 and December 31, 2017 in Hong Kong. Among the 14 614 patients matched by propensity score (7307 patients in each group), 558 (7.6%) and 787 (10.8%) patients died during the observation period in the radial group and femoral group, respectively, resulting in annualized all‐cause mortality rates of 2.69% and 3.87%, respectively. The radial group had a lower risk of all‐cause mortality compared with the femoral group up to 3 years after percutaneous coronary intervention (hazard ratio [HR], 0.70; 95% CI, 0.63–0.78;
P
<0.001). Radial access was associated with a lower risk of major adverse cardiac events (HR, 0.78; 95% CI, 0.73–0.83,
P
<0.001), myocardial infarction after hospital discharge (HR, 0.78; 95% CI, 0.70–0.87,
P
<0.001), and unplanned revascularization (HR, 0.76; 95% CI, 0.68–0.85,
P
<0.001). The risks of stroke were similar across the 2 groups (HR, 0.96; 95% CI, 0.82–1.13,
P
=0.655).
Conclusions
Radial access was associated with a significant reduction in all‐cause mortality at 3 years compared with femoral access. Radial access was associated with reduced risks of myocardial infarction and unplanned revascularization, but not stroke. The benefits were sustained beyond the early postoperative period.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
5 articles.
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