title: Impact of transradial coronary intervention on bleeding complications in octogenarians.
abstract: Percutaneous coronary intervention (PCI) in the elderly is a major hospital burden since this group of patients exhibits high mortality rates and many comorbidities. The aim of this study was to analyze the impact of a transradial intervention (TRI) approach for PCI on bleeding complications in octogenarians. We retrospectively analyzed a consecutive cohort of 2530 patients who underwent PCI at a tertiary care center in Japan. Octogenarians constituted 12 % (291 cases) of the total PCI cases during the study period. Bleeding complications and all-cause mortality were observed at 30 days after PCI. Average age was 83 ± 3 years and female gender was 32 %. Stable coronary artery disease was 59 %. TRI was performed in 218 patients (75 %) and transfemoral intervention (TFI) in 73 (25 %). Bleeding Academic Research Consortium (BARC) major bleeding unrelated to bypass surgery were observed in 7.6 %, which were significantly lower in TRI than TFI (5.1 vs. 15.1 %, P = 0.005). The 30-day mortality rate was significantly low in patients without bleeding (4.9 vs. 31 %, p < 0.0001). In octogenarians, major bleeding complication was significant at 30 days after PCI. TRI had lower bleeding complication rate than TFI in this population. Octogenarians may be a subgroup of patients who derive benefits from TRI.
authors.affiliation: Cardiac Center of Excellence, International Medical Center, Jeddah, Saudi Arabia.
authors.forename: Khalid
authors.initials: K
authors.lastname: Tammam
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, Isehara, 259-1193, Japan. ikari@is.icc.u-tokai.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, Isehara, 259-1193, Japan.
authors.forename: Fuminobu
authors.initials: F
authors.lastname: Yoshimachi
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, Isehara, 259-1193, Japan.
authors.forename: Fumie
authors.initials: F
authors.lastname: Saito
authors.affiliation: Cardiac Center of Excellence, International Medical Center, Jeddah, Saudi Arabia.
authors.forename: Walid
authors.initials: W
authors.lastname: Hassan
mesh_terms: D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology*; D017534:Radial Artery; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
keywords: Bleeding complications; Elderly; Percutaneous coronary intervention; Transradial intervention