title: Transradial versus transfemoral access for female patients who underwent primary PCI in STEMI: Two years follow-up data from acute STEMI interventional registry.
abstract: BACKGROUND
  Female patients possess a higher risk for poorer outcome in ST segment elevation myocardial infarction (STEMI). There is possibility that transradial access (TRA) for primary percutaneous coronary intervention (PPCI) could provide better outcome than transfemoral access (TFA) in female patients with STEMI.
  
  
  METHODS
  From 2008 to 2010, 418 female patients (out of 1808 patients) underwent PPCI for acute STEMI. The registry recruited all-comers patients with acute STEMI. Cardiac mortality, major bleeding, and overall MACE rates (composite of death, stroke, re MI and target vessel revascularization-TVR) after 2years follow-up were compared between TRA and TFA.
  
  
  RESULTS
  TRA for PPCI was performed in 261 patients and 157 underwent TFA PPCI. The 30-days, 1year mortality and 2year mortality rates were lower in TRA compared to TFA (6.9% vs.14.6%, p=0.012, 8.8% vs. 15.3%, p=0.045, and 9.2% vs. 16.6%, p=0.027respectively). After 2years follow-up, the overall MACE rates were similar (26.4% vs. 31.2%, p=0.336). The overall major bleeding and major vascular access site bleeding were more favorable for TRA than TFA (4.4 vs. 14%, p<0.001, and 2.7 vs. 10.8%, p<0.001, respectively).
  
  
  CONCLUSIONS
  Transradial access for primary PCI in female patients provided better clinical outcomes with lower cardiac mortality and reduced major bleeding in comparison to TFA. There was no significant difference at 2years MACE between TRA and TFA.
authors.affiliation: University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia. Electronic address: skedev@gmail.com.
authors.forename: Sasko
authors.initials: S
authors.lastname: Kedev
authors.affiliation: Harapan Kita National Cardiovascular Center, Department of Cardiology & Vascular Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: Renan
authors.initials: R
authors.lastname: Sukmawan
authors.affiliation: University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia.
authors.forename: Oliver
authors.initials: O
authors.lastname: Kalpak
authors.affiliation: Harapan Kita National Cardiovascular Center, Department of Cardiology & Vascular Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: Surya
authors.initials: S
authors.lastname: Dharma
authors.affiliation: University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Antov
authors.affiliation: University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia.
authors.forename: Jorgo
authors.initials: J
authors.lastname: Kostov
authors.affiliation: University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia.
authors.forename: Hristo
authors.initials: H
authors.lastname: Pejkov
authors.affiliation: University Clinic of Cardiology, St Cyril & Methodius University, Skopje, Macedonia.
authors.forename: Igor
authors.initials: I
authors.lastname: Spiroski
mesh_terms: D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017534:Radial Artery / Q000601:surgery*; D012042:Registries; D000072657:ST Elevation Myocardial Infarction / Q000601:surgery*; D016896:Treatment Outcome
keywords: Outcomes; ST-segment elevation myocardial infarction, primary PCI; Transradial access; Women