Comparison of Transradial and Transfemoral Approaches in Women Undergoing Percutaneous Coronary Intervention in China: A Retrospective Observational Study

Angiology ◽  
2017 ◽  
Vol 68 (9) ◽  
pp. 799-806 ◽  
Author(s):  
Chen Jin ◽  
Yi Xu ◽  
Shubin Qiao ◽  
Xinran Tang ◽  
Yongjian Wu ◽  
...  

Despite increasing adoption of the transradial approach for percutaneous coronary intervention (PCI) in clinical practice, the role of transradial intervention (TRI) in women remains a significant debate. We identified 1392 women from a consecutive cohort of patients undergoing PCI in China in 2010 and compared the efficacy and hospital costs between TRI and transfemoral intervention. An inverse probability weighting (IPW) method was used to control for potential bias. After IPW adjustment, patients receiving TRI were less likely to experience post-PCI bleeding (adjusted odds ratio [OR]: 0.46, 95% confidence interval [CI]: 0.30-0.71) and major adverse cardiac events (adjusted OR 0.35, 95% CI 0.19-0.63) and more likely to have shorter length of stay in hospital (1.2 days difference, 95% CI: 0.6-1.7). Moreover, TRI was associated with a cost saving of ¥ (Yuan Renminbi) 7474 (approximately US$1150, 95% CI: ¥2993-¥11 624). More than 70% of this saving was driven by lower PCI-related costs. In conclusion, the use of TRI in women was associated with more favorable outcomes and lower hospital costs.

2014 ◽  
Vol 111 (06) ◽  
pp. 1060-1066 ◽  
Author(s):  
Iciar Arbesu ◽  
Bernd Jilma ◽  
Gerald Maurer ◽  
Irene M. Lang ◽  
Christine Mannhalter ◽  
...  

SummaryThe single nucleotide polymorphism (SNP) rs342293 has been shown to influence platelet number and mean platelet volume (MPV). We investigated the association between the rs342293 polymorphism and cardiovascular outcome in a prospective cohort study. The rs342293 polymorphism was analysed in 404 patients with coronary artery disease undergoing percutaneous coronary intervention. The rates of cardiac adverse events were recorded during two years of follow-up. The polymorphism was associated with MPV (median 10.1 fL, interquartile range [IQR]: 9.6 to 10.6 in patients with the CC-allele vs 10.4 fL, IQR: 9.9 to 11.1 in G>C SNP carriers; p<0.001), but not with platelet count. Survival analysis indicated that carriers of the rs342293 G variant had a substantially higher risk to develop cardiac adverse events compared with wild type carriers during two years of follow-up (33% vs 22%; adjusted hazard ratio = 1.63, 95% confidence interval = 1.06–2.52, p=0.027). The rs342293 SNP could explain 2.9% of the variability in MPV (p=0.01). In conclusion, patients undergoing coronary stenting who carry the G-variant of the rs342293 SNP which is associated with larger MPV are at higher risk for adverse cardiovascular outcome.


2005 ◽  
Vol 4 (2) ◽  
pp. 113-116 ◽  
Author(s):  
Paul Dendale ◽  
Jan Berger ◽  
Dominique Hansen ◽  
Johan Vaes ◽  
Edouard Benit ◽  
...  

Background: Despite multiple publications on effects of rehabilitation in cardiac patients, rehabilitation is not fully known to be of value in post-percutaneous coronary intervention (PCI) patients. Aims: To investigate the influence of cardiac rehabilitation on the incidence of major adverse cardiac events (MACEs) in post-PCI patients. Methods: Retrospectively and nonrandomized 140 post-PCI patients (107 males, mean age 62 (7) years) participated in a 3-month rehabilitation program, starting 2 weeks post-PCI, while 83 post-PCI patients (54 males, mean age 68 (8) years) did not and were all followed up for 15 months. Data on cardiac medication prescription and incidence of MACE (including angina pectoris with or without reintervention, restenosis, myocardial infarction, revascularisation with re-PCI or CABG, and death) were collected. The relationship with cardiovascular risk factors including sex, smoking behaviour, obesity, diabetes mellitus, hypertension, familiar predisposition, and hypercholesterolemia was analysed. Results: The incidence of total MACE in the rehabilitation group is significantly lower than in the control group (24% vs. 42%, respectively; P<0.005). The incidence of documented restenosis, angina pectoris with resulting reintervention, all revascularisations, and death is significantly lower in the rehabilitation group, compared with the control group. Conclusion: The incidence of MACE and restenosis is significantly lower when PCI patients are included in a cardiac rehabilitation program.


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