A comparison of transradial and transfemoral approaches for percutaneous coronary intervention in elderly patients based on a propensity score analysis.
The transradial approach (TRA) has been used as access site for percutaneous coronary intervention (PCI) for years. However, no large sample study has evaluated the effect of TRA in elderly patients. A total of 1098 elderly patients (age ≥ 75 years) who underwent PCI by TRA or transfemoral approach were recruited. A 1:1 matched propensity score analysis was performed to minimize bias. The rates of major adverse cardiovascular events that included death, myocardial infarction (MI), and target vessel revascularization during hospitalization (1.3% vs 6.6%, P = .014) and at 1-year follow-up (6.0% vs 13.9%, P = .019) were significantly lower in the TRA group. Transradial approach was also associated with lower rates of in-hospital MI (1.3% vs 5.3%, P = .046), access-site complications (3.3% vs 9.9%, P = .018), and major bleeding (1.3% vs 5.3%, P = .046). In conclusion, TRA showed better safety in elderly patients; it should be considered as a preferred route for elderly patients.
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Pei-Yuan
PY
He
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China yangyuejin_fuwai@126.com.
Yue-Jin
YJ
Yang
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Shu-Bin
SB
Qiao
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Bo
B
Xu
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Min
M
Yao
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yong-Jian
YJ
Wu
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Jin-Qing
JQ
Yuan
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Jue
J
Chen
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Hai-Bo
HB
Liu
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Jun
J
Dai
Medical Research & Biometrics Center, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Xin-Ran
XR
Tang
Medical Research & Biometrics Center, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Yang
Y
Wang
Medical Research & Biometrics Center, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Wei
W
Li
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Run-Lin
RL
Gao
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005263:Femoral Artery; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057216:Propensity Score; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017534:Radial Artery; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
access site; coronary artery disease; elderly; percutaneous coronary intervention; transfemoral; transradial