title: Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention.
abstract: BACKGROUND
  Radial artery spasm (RAS) is the most common complication in transradial coronary angiography and intervention. In this study, we designed to investigate the incidence of RAS during transradial procedures in Chinese, find out the independent predictors through multiple regression, and analyze the clinical effect of RAS during follow-up.
  
  
  METHODS
  Patients arranged to receive transradial coronary angiography and intervention were consecutively enrolled. The incidence of RAS was recorded. Univariate analysis was performed to find out the influence factors of RAS, and logistic regression analysis was performed to find out the independent predictors of RAS. The patients were asked to return 1 month later for the assessment of the radial access.
  
  
  RESULTS
  The incidence of RAS was 7.8% (112/1427) in all the patients received transradial procedure. Univariate analysis indicates that young (P = 0.038), female (P = 0.026), small diameter of radial artery (P < 0.001), diabetes (P = 0.026), smoking (P = 0.019), moderate or severe pain during radial artery cannulation (P < 0.001), unsuccessful access at first attempt (P = 0.002), big sheath (P = 0.004), number of catheters (> 3) (P = 0.048), rapid baseline heart rate (P = 0.032) and long operation time (P = 0.021) were associated with RAS. Logistic regression showed that female (OR = 1.745, 95%CI: 1.148 - 3.846, P = 0.024), small radial artery diameter (OR = 4.028, 95%CI: 1.264 - 12.196, P = 0.008), diabetes (OR = 2.148, 95%CI: 1.579 - 7.458, P = 0.019) and unsuccessful access at first attempt (OR = 1.468, 95%CI: 1.212 - 2.591, P = 0.032) were independent predictors of RAS. Follow-up at (28 +/- 7) days after the procedure showed that, compared with non-spasm patients, the RAS patients had higher portion of pain (11.8% vs. 6.2%, P = 0.043). The occurrences of hematoma (7.3% vs. 5.6%, P = 0.518) and radial artery occlusion (3.6% vs. 2.6%, P = 0.534) were similar.
  
  
  CONCLUSIONS
  The incidence of RAS during transradial coronary procedure was 7.8%. Logistic regression analysis showed that female, small radial artery diameter, diabetes and unsuccessful access at first attempt were the independent predictors of RAS.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: De-An
authors.initials: DA
authors.lastname: Jia
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Shi
authors.forename: Yu-Yang
authors.initials: YY
authors.lastname: Liu
authors.forename: Jian-Long
authors.initials: JL
authors.lastname: Wang
authors.forename: Xiao-Li
authors.initials: XL
authors.lastname: Liu
authors.forename: Zhi-Jian
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Shi-Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Hai-Long
authors.initials: HL
authors.lastname: Ge
authors.forename: Bin
authors.initials: B
authors.lastname: Hu
authors.forename: Zhen-Xian
authors.initials: ZX
authors.lastname: Yan
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
mesh_terms: D000367:Age Factors; D000368:Aged; D017023:Coronary Angiography / Q000009:adverse effects*; D003329:Coronary Vasospasm / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D012737:Sex Factors