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Transradial versus transfemoral intervention in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention 원문보기

  • 저자

    Li Hu

  • 학위수여기관

    고려대학교 대학원

  • 학위구분

    국내석사

  • 학과

    의학과 내과학전공

  • 지도교수

    나승운

  • 발행년도

    2014

  • 총페이지

    30 p.

  • 키워드

    심장학;

  • 언어

    eng

  • 원문 URL

    http://www.riss.kr/link?id=T13541950&outLink=K  

  • 초록

    Objectives We aimed to compare major clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). Background TRI is drastically increasing in every intervention society in all over the world because of the lower incidence of major bleeding and vascular complications compared with TFI. However, there have been very limited published data regarding clinical outcomes of TRI versus TFI in Asian STEMI patients (pts). Methods A total 689 consecutive STEMI pts who underwent primary PCI with DESs from nine major PCI hospitals were enrolled from January to December 2009. Angiographic outcomes and cumulative clinical outcomes up to 12-months were compared between TRI group (n=220, 31.9%) and TFI group (n=469, 28.1%). Results Baseline characteristics showed that TFI group had more smokers, higher incidence of hypertension, diabetes mellitus, multi-vessel disease, left circumflex lesion, type B2 or C lesion and chronic total occlusion lesion. In-hospital complications showed that TRI group had lower incidence of major and minor hemorrhage. Clinical outcomes up to 12-months showed that the incidence of recurrent myocardial infarction, target lesion revascularization (TLR), and target vessel revascularization (TVR) were lower in the TRI group. There were no significant differences in in-hospital and 1-yr mortality rates between the two groups. After propensity score matched analysis, TRI was an independent predictor of reducing TVR (OR: 0.09 95% CI: 0.01-0.67, p Value=0.019), major adverse cardiac events (MACE, odd ratio [OR]: 0.37, 95% confidence Interval [CI]: 0.15-0.86, p Value=0.022), and major adverse cardiac and cerebrovascular events (MACCE, OR: 0.33, 95% CI: 0.14-0.76, p Value=0.010) at 12 months. Conclusions In our study, TRI in STEMI pts undergoing primary PCI with DESs was associated with less incidence of access site hematoma and lower 12-months TVR, MACE and MACCE compared with TFI. We suggest that TRI may play an important role in improving mid-term major clinical outcomes of STEMI pts undergoing primary PCI with DESs.


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