title: Arterial Access in Patients With De Novo Acute Coronary Syndrome Undergoing Coronary Angiography.
abstract: Bleeding is a major limitation of antithrombotic therapy among invasively managed patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACSs). Randomized clinical trials have generally failed to favor either the femoral or the radial arterial approach for coronary angiography or intervention in NSTE-ACS. In 561 hospitalized patients with a new diagnosis of NSTE-ACS referred for coronary angiography, 364 and 197 patients underwent the femoral and the radial approach, respectively. Femoral and radial access did not differ in bleeding complications in the first 72 hours (8 of 364 or 2.2% vs 8 of 197 or 4.1%, P = .21), duration of hospitalization (4.67 ± 5.02 vs 4.51 ± 4.81, P = .28) nor in-hospital mortality (0.8% vs 0.5%, P = .67). Contrast volume was higher for femoral versus radial cases (204 ± 119 vs 168 ± 104, P < .001). In patients with de novo NSTE-ACS without prior cardiac bypass, radial and femoral arterial access did not differ in instances of bleeding within the first 72 hours postoperatively, length of hospital stay, or in-hospital mortality. Less contrast was used in radial cases, which may represent an advantage for patients with renal insufficiency.
authors.affiliation: 1 Cardiology Division, Department of Internal Medicine, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.|2 Division of Cardiovascular Medicine, Department of Medicine, The University of Toledo Medical Center, Toledo, OH, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Abdul Jabbar
authors.affiliation: 1 Cardiology Division, Department of Internal Medicine, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.
authors.forename: Omar
authors.initials: O
authors.lastname: Mufti
authors.affiliation: 1 Cardiology Division, Department of Internal Medicine, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.
authors.forename: Angeline
authors.initials: A
authors.lastname: Sabol
authors.affiliation: 1 Cardiology Division, Department of Internal Medicine, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Markert
authors.affiliation: 1 Cardiology Division, Department of Internal Medicine, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: White
authors.affiliation: 1 Cardiology Division, Department of Internal Medicine, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA.
authors.forename: George
authors.initials: G
authors.lastname: Broderick
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D003287:Contrast Media; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media
keywords: non-ST-segment elevation acute coronary syndrome; transradial; vascular access