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Title: Trends in vascular access for patients undergoing percutaneous coronary intervention in Australia: a report from the Melbourne Interventional Group Cohort.
Author: Khialani, B.
Andrianopoulos, Nick
Yip, T.
Ajani, A.
Yudi, M.
Freeman, M.
Jaworski, C.
Oqueli, Ernesto
Brennan, A.
Duffy, S.
Hutchison, S.
Hiew, C.
Sebastian, M.
Stub, Dion.
Issue Date: 2018
Conference Name: 66th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 12th Annual Australia and New Zealand Endovascular Therapies Meeting.
Conference Date: August 2-5th
Conference Place: Brisbane, Queensland
Abstract: Background: This study sought to examine the rate of adoption of the transradial approach (TRA) amongst acute coronary syndrome (ACS) and non-ACS patients undergoing percutaneous coronary intervention (PCI), and to evaluate whether it is associated with superior clinical outcomes. Methods: Temporal trends in using TRA between 2005 and 2017 were assessed in 26,896 patients who underwent PCI with ACS (n = 18,025) and without ACS (n = 8,871) from the Melbourne Interventional Group registry. Clinical and procedural variables, and clinical outcomes were compared between the TRA and femoral access (FA). The primary outcomes were in-hospital bleeding and 30-day major adverse cardiac and cerebrovascular events (MACCE: death, myocardial infarction, target vessel revascularisation, and stroke). Results: Use of the TRA significantly increased from 3.3% (ACS) and 1.4% (non-ACS) in 2005 to 67.0% and 65.0%, respectively, by 2017 (p-for trend <0.01). The TRA was more likely to be used in ACS patients for urgent or rescue PCI, and in those who had received thrombolysis (p < 0.01). There were significantly lower in-hospital bleeding rates using TRA compared to FA in both ACS (1.0% vs 2.4%, p < 0.01)) and non-ACS (0.3% vs 1.1%, p < 0.01) cohorts. Multivariable analyses showed that vascular access (FA vs TRA) was not an independent predictor of 30-day MACCE in ACS (OR 1.01, 95% CI 0.85–1.21) and non-ACS (OR 0.95, 95% CI 0.69–1.32). Conclusions: During a 13-year period there was a marked increase in transradial PCI in Victoria for both ACS and non-ACS patients. Transradial PCI was associated with significantly lower bleeding rates but equivalent MACCE rates.
Internal ID Number: 01253
Type: Conference
Appears in Collections:Research Output

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