The in-hospital outcome and predictors of major adverse cardiac events after transradial intervention in patients with coronary artery disease
10.3760/cma.j.issn.0253-3758.2011.03.009
- VernacularTitle:经桡动脉介入治疗冠心病的住院期间疗效和主要不良心脏事件的预测因素
- Author:
Sheng-Wen LIU
1
;
Shu-Bin QIAO
;
Bo XU
;
Xue-Wen QIN
;
Min YAO
;
Jin-Qing YUAN
;
Jue CHEN
;
Hai-Bo LIU
;
Shi-Jie YOU
;
Feng-Huan HU
;
Yuan WU
;
Jun DAI
;
Pei ZHANG
;
Wei-Xian YANG
;
Ke-Fei DOU
;
Hong QIU
;
Zhan GAO
;
Chao-Wei MU
;
Wei-Hua MA
;
Yong-Jian WU
;
Jian-Jun LI
;
Yue-Jin YANG
;
Ji-Lin CHEN
;
Run-Lin GAO
Author Information
1. 中国医学科学院,北京协和医学院,阜外心血管病医院
- Keywords:
Angioplasty,transluminal,percutaneous coronary;
Radial artery;
Coronary disease
- From:
Chinese Journal of Cardiology
2011;39(3):208-211
- CountryChina
- Language:Chinese
-
Abstract:
Objective The purpose of this study is to evaluate the in-hospital clinical outcome of patients with coronary artery disease who underwent transradial intervention (TRI) and analyze the predictors of chinical outcome. Methods From May 2004 to May 2009, there were 16 281 patients who underwent transradial intervention, as well as 5388 patients who underwent transfemoral intervention (TFI) at our institution. The clinical characteristics, procedural characteristics, and in-hospital clinical adverse events were compared between TRI and TFI groups. Multivariable logistic regression analysis was performed to determine predictors of in-hospital major adverse cardiac events ( composite of death, myocardial infarction,or target lesion revascularization) of TRI. Results The annulations time was significantly longer for TRIthan TFI (P ＜0. 01 ), fluoroscopy time, amount of contrast agent and procedural success rate (95.5% for TRI and 96. 2% for TFI) were similar between the two groups. However, the rates of vascular complications (0. 1% for TRI group and 1.3% for TFI group, P ＜0. 01 ), incidence of in-hospital major adverse cardiac events (1.6% vs. 3. 8%, P＜ 0.01) and in-hospital death (0.2% vs. 0.4%, P＜0.01) were all significantly lower in TRI group compared with TFI group. The following characteristics were identified as independent multivariate predictors of in-hospital major adverse cardiac events of TRI: age ≥65 ( OR: 1.98,95% CI: 1. 50 - 2. 61, P ＜ 0. 01 ), prior myocardial infarction ( OR:2. 14, 95% CI: 1.63 - 2. 82, P ＜0. 01 ), use of drug-eluting stent (DES) ( OR:0. 68, 95% CI:0. 47 - 0. 98, P = 0. 04 ), dissection during procedure (OR:4.08, 95%CI:2.28-7.33, P＜0.01), left main lesion (OR:2. 12, 95% CI:1.09-4. 13, P=0.03), number of implanted stents (OR:1.25, 95% CI:1.09 - 1.43, P ＜0.01), and total stented length (OR:1.01, 95% CI:1. 00 -1. 02 , P=0.03). Conclusions In this large single-centre patient cohort, the transradial intervention is superior to transfemoral intervention in terms of in-hospital safety and efficacy. Age ≥ 65, prior myocardial infarction, use of DES, dissection during procedure, left main lesion, number of implanted stents and total stented length were identified as independent multivariate predictors of in-hospital major adverse cardiac events of TRI.
