Korean Circ J.  2018 Aug;48(8):719-727. 10.4070/kcj.2018.0040.

A Comparison of Transradial and Transfemoral Percutaneous Coronary Intervention in Chinese Women Based on a Propensity Score Analysis

• Xu Y
• Jin C
• Qiao S
• Wu Y
• Yan H
• Dou K
• Xu B
• Yang J
• Yang Y

• KMID: 2417695
• DOI: http://doi.org/10.4070/kcj.2018.0040

Abstract

BACKGROUND AND OBJECTIVES
Over the past decades, transradial approach for percutaneous coronary intervention (PCI) has been increasingly adopted in clinical practice. Women represent a large population who will possibly benefit from PCI, but they are often under-represented in clinical studies. Therefore, the role of TRI in women remains to be further defined. This study sought to compare safety and efficacy for transradial intervention (TRI) and transfemoral intervention (TFI) in women undergoing PCI in China.
METHODS
The study population consisted of 5,067 women undergoing PCI at Fuwai Hospital, Beijing, China between 2006 and 2011 (TRI: n=4,105, TFI: n=962). Incidence rates of clinical outcomes during hospitalization and at 1-year follow-up were compared between TRI and TFI. In order to minimize potential biases, a 1:1 propensity score matching (PSM) was performed. A total of 899 pairs were matched.
RESULTS
Baseline and procedural characteristics were well-balanced between TRI and TFI groups after controlling for confounders using PSM. TRI was associated with reduced major post-PCI bleeding (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.54-0.76; p < 0.001) and access site complications (OR, 0.67; 95% CI, 0.61-0.74; p < 0.001) after PSM. There was no statistical differences in the incidence rates of major adverse cardiac events (a composite of cardiac death, myocardial infarction, and target vessel revascularization) both during hospitalization and at 1-year follow-up (p > 0.05).
CONCLUSIONS
In this propensity score-based analysis of TRI versus TFI in Chinese women, TRI showed advantages of safety and feasibility over TFI. A wider adoption of TRI in women has the potential to improve outcomes in treatment of coronary artery diseases.

Keyword

Coronary artery disease; Percutaneous coronary intervention; Women; Radial artery; Femoral artery

MeSH Terms

Asian Continental Ancestry Group*
Beijing
Bias (Epidemiology)
China
Coronary Artery Disease
Death
Female
Femoral Artery
Follow-Up Studies
Hemorrhage
Hospitalization
Humans
Incidence
Myocardial Infarction
Percutaneous Coronary Intervention*
Propensity Score*
Radial Artery

Figure

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  Figure 1 Comparison of bleeding and access site complication between TRI and TFI groups in propensity score-matched patients. BARC = Bleeding Academic Research Consortium; TFI = transfemoral intervention; TRI = transradial intervention.

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  Figure 2 Kaplan-Meier curves for occurrence of MACE (A), cardiac death (B), MI (C), and TVR (D) between TRI and TFI groups of 1-year follow-up in propensity score-matched patients. MACE = major adverse cardiac event; MI = myocardial infarction; TFI = transfemoral intervention; TRI = transradial intervention; TVR = target vessel revascularization.

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