17 Radial vs. femoral access in heat-PPCI: MACE and bleeding outcomes - exploring the limitations of observational research. (24th April 2016)

• Record Type: Journal Article
• Authors: Kumar, Abhishek; Aggarwal, Suneil K; Imran, Syed S; Shahzad, Adeel; Stables, Rodney H
• Is Part Of: Heart. Volume 102(2016)Supplement 4
• Page Start: A9
• Page End: A9
• Publication Date: 2016-04-24
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2016-309588.17
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Primary Percutaneous Coronary Intervention (PPCI) through the radial artery is considered to be safer in the hands of operators, experienced in that approach. We examined the impact of radial and femoral access in the HEAT-PPCI trial. Methods: We compared the primary safety and efficacy outcomes* at 28 days, by final access site used (radial or femoral) and by default operator type. We then specifically assessed outcomes in femoral cases performed by both, default radial and femoral operators. Findings: 1804 cases were included in the final analysis. In a simple analysis, radial access was associated with significantly fewer MACE and bleeding events.* When analysed by default operator type, the incidence of MACE and bleeding events were similar.* In the femoral cases done by radial or femoral operators, MACE and bleeding events were significantly worse for the radial operators, potentially explained by less favourable baseline characteristics.* Interpretation: In this unselected, real-world population treated with PPCI, default femoral operators, when compared to high volume radial operators, achieved comparable MACE outcomes but at the expense of increased bleeding - mainly minor bleeding. The less favourable outcomes observed for femoral access in the whole population is probably due to its use by radial operators in high risk cases. *See Table