title: Comparison of Transradial and Transfemoral Approaches for Percutaneous Coronary Intervention in Patients With Acute Coronary Syndrome and Anemia.
abstract: Anemia is an independent predictor of bleeding complications and poor clinical outcomes after percutaneous coronary intervention. Percutaneous coronary transradial intervention (TRI) is better than percutaneous coronary transfemoral intervention (TFI) in terms of reducing bleeding complications that can affect the prognosis. This study aims to investigate the clinical outcomes between TRI and TFI for patients with anemia. We analyzed periprocedure complications, in-hospital mortality, and major adverse cardiac events for one year in the Korean TRI registry from January 2013 to April 2014. Patients with chronic kidney disease for whom TFI is preferred were excluded. Anemia was defined as hemoglobin <13 g/dl for men and <12 g/dl for women. A total of 1,279 patients were finally enrolled. Of these, 348 patients had anemia. Among them, 253 patients (72.7%) underwent TRI and 95 patients (27.3%) underwent TFI. There were no significant differences of baseline demographic characteristics between the TRI and TFI groups, except for the incidence of dyslipidemia (TRI 23.7% vs TFI 12.6%, p = 0.023). Multivariate logistic regression analysis revealed lower incidence of composite severe bleeding complications (hazard ratio 0.34, 95% CI 0.12 to 0.99, p = 0.049) and lower incidence of in-hospital mortality than TFI group (hazard ratio 0.74, 95% CI 0.62 to 0.88, p = 0.042). In conclusion, this study suggests that the TRI for patients with anemia may be translated into better prognosis in terms of lower rates of bleeding complications and in-hospital mortality.
authors.affiliation: The Heart Center of Chonnam, National University Hospital, Gwangju, Korea.
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: The Heart Center of Chonnam, National University Hospital, Gwangju, Korea. Electronic address: myungho@chollian.net.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Department of Cardiology, Hallym University Kandong Sacred Heart Hospital, Seoul, Korea. Electronic address: krheart@hallym.or.kr.
authors.forename: Kyoo Rok
authors.initials: KR
authors.lastname: Han
authors.affiliation: The Heart Center of Chonnam, National University Hospital, Gwangju, Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: Department of Cardiology, Yonsei University, Wonju Christian Hospital, Wonju, Korea.
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.affiliation: Department of Cardiology, Yonsei University, Wonju Christian Hospital, Wonju, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Youn
authors.affiliation: Department of Cardiology, Kangwon National University Hospital, Chuncheon, Korea.
authors.forename: Byung Ryeol
authors.initials: BR
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Pusan National University Hospital, Busan, Korea.
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.affiliation: Department of Cardiology, Soonchunhyang University Seoul Hospital, Seoul, Korea.
authors.forename: Min Su
authors.initials: MS
authors.lastname: Hyon
authors.affiliation: Department of Cardiology, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Department of Cardiology, Inje University Sanggye Paik Hospital, Goyang, Korea.
authors.forename: Byung Ok
authors.initials: BO
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Won Yong
authors.initials: WY
authors.lastname: Shin
authors.affiliation: Department of Cardiology, Inha University Hospital, Incheon, Korea.
authors.forename: Keum Soo
authors.initials: KS
authors.lastname: Park
authors.affiliation: Department of Cardiology, Ulsan University GangNeung Asan Hospital, Gangneung, Korea.
authors.forename: Sang Sig
authors.initials: SS
authors.lastname: Cheong
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000209:etiology*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000150:complications* / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D017534:Radial Artery; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology