The Impact of Vascular Access for In-Hospital Major Bleeding in Patients with Acute Coronary Syndrome at Moderate- to Very High-Bleeding Risk.
10.3346/jkms.2013.28.9.1307
- Author:
Keun Ho PARK
1
;
Myung Ho JEONG
;
Youngkeun AHN
;
Sang Sik JUNG
;
Moo Hyun KIM
;
Hyoung Mo YANG
;
Junghan YOON
;
Seung Woon RHA
;
Keum Soo PARK
;
Kyoo Rok HAN
;
Byung Ryul CHO
;
Kwang Soo CHA
;
Byung Ok KIM
;
Min Soo HYON
;
Won Yong SHIN
;
Hyunmin CHOE
;
Jang Whan BAE
;
Hee Yeol KIM
Author Information
1. Chonnam National University Hospital, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article ; Multicenter Study
- Keywords:
Acute Coronary Syndrome;
Radial Artery;
Hemorrhage
- MeSH:
Acute Coronary Syndrome/mortality/*pathology;
Aged;
Female;
Femoral Artery;
*Hemorrhage;
Hospital Mortality;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Odds Ratio;
Percutaneous Coronary Intervention;
Radial Artery;
Retrospective Studies;
Risk Factors;
Stents;
Treatment Outcome
- From:Journal of Korean Medical Science
2013;28(9):1307-1315
- CountryRepublic of Korea
- Language:English
-
Abstract:
The aim of our study was to determine the impact of vascular access on in-hospital major bleeding (IHMB) in acute coronary syndrome (ACS). We analyzed 995 patients with non-ST elevation myocardial infarction and unstable angina at the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) moderate- to very high-bleeding risk scores in trans-radial intervention (TRI) retrospective registry from 16 centers in Korea. A total of 402 patients received TRI and 593 patients did trans-femoral intervention (TFI). The primary end-point was IHMB as defined in the CRUSADE. There were no significant differences in in-hospital and 1-yr mortality rates between two groups. However, TRI had lower incidences of IHMB and blood transfusion than TFI (6.0% vs 9.4%, P = 0.048; 4.5% vs 9.4%, P = 0.003). The patients suffered from IHMB had higher incidences of in-hospital and 1-yr mortality than those free from IHMB (3.1% vs 15.0%, P < 0.001; 7.2% vs 30.0%, P < 0.001). TRI was an independent negative predictor of IHMB (odds ratio, 0.305; 95% confidence interval, 0.109-0.851; P = 0.003). In conclusions, IHMB is still significantly correlated with in-hospital and 1-yr mortality. Our study suggests that compared to TFI, TRI could reduce IHMB in patients with ACS at moderate- to very high-bleeding risk.
