title: Impact of Arterial Access Route on Bleeding Complications in Japanese Patients Undergoing Percutaneous Coronary Intervention- Insight From the PRASFIT Trial.
abstract: BACKGROUND
  Few large-scale studies have examined the relationship between bleeding events not related to coronary artery bypass grafting (CABG), and the vascular access route used in acute coronary syndrome (ACS) or in elective treatment of coronary artery disease (CAD).
  
  
  RESULTS
  We compared the incidence of bleeding events occurring up to 3 days after percutaneous coronary intervention (PCI) or loading dose of prasugrel or clopidogrel in 2 studies of Japanese patients (PRASFIT-ACS, femoral and radial routes, n=683 and 531; PRASFIT-Elective, femoral and radial routes, n=135 and 508). Rates of periprocedural bleeding, bleeding not related to CABG, and puncture site bleeding were consistently lower in the radial access route group than in the femoral access route group in both studies. Risk factors for periprocedural bleeding included sex, body weight, age, and access route in PRASFIT-ACS (femoral access: hazard ratio [HR], 3.739; 95% confidence interval [CI]: 1.727-8.094; radial access: HR, 0.288; 95% CI: 0.128-0.65), and body weight, age, and access route in PRASFIT-Elective (femoral access: HR, 12.32; 95% CI 1.282->100; radial access: HR, 0.125; 95% CI: 0.013-1.205).
  
  
  CONCLUSIONS
  The incidence of periprocedural bleeding is lower with a radial access route than with a femoral access route for PCI in Japanese patients with ACS or those undergoing elective PCI for CAD.
authors.affiliation: Division of Cardiology, Shonan Kamakura General Hospital.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
authors.forename: Takaaki
authors.initials: T
authors.lastname: Isshiki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Nishikawa
authors.forename: Shunichi
authors.initials: S
authors.lastname: Miyazaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006470:Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*