Effectiveness of the transradial approach to reduce bleedings in patients undergoing urgent coronary angioplasty with GPIIb/IIIa inhibitors for acute coronary syndromes
| العنوان: | Effectiveness of the transradial approach to reduce bleedings in patients undergoing urgent coronary angioplasty with GPIIb/IIIa inhibitors for acute coronary syndromes |
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| المؤلفون: | A. Sonia Petronio, Roberto Gistri, A Mazzoni, Gabriele Borelli, Marco Arena, Nicola Ciabatti, Marco De Carlo |
| المصدر: | Catheterization and Cardiovascular Interventions. 74:408-415 |
| بيانات النشر: | Wiley, 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Acute coronary syndrome, medicine.medical_treatment, Hemorrhage, Platelet Glycoprotein GPIIb-IIIa Complex, Punctures, Risk Assessment, Severity of Illness Index, Transradial catheterization, Risk Factors, Internal medicine, Odds Ratio, medicine, Humans, Blood Transfusion, Radiology, Nuclear Medicine and imaging, Prospective Studies, Registries, Myocardial infarction, Acute Coronary Syndrome, Angioplasty, Balloon, Coronary, Emergency Treatment, Aged, Aged, 80 and over, business.industry, Percutaneous coronary intervention, General Medicine, Thrombolysis, Middle Aged, medicine.disease, Surgery, Femoral Artery, Logistic Models, Glycoprotein IIb/IIIa inhibitors, Radial Artery, Conventional PCI, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, TIMI, medicine.drug |
| الوصف: | Objectives: To analyze the effectiveness of the transradial approach in reducing bleeding rates following urgent percutaneous coronary intervention (PCI) in patients with acute coronary syndromes treated with glycoprotein IIb/IIIa inhibitors (GPIs). Background: PCI and use of GPIs are recommended in acute coronary syndromes, but are strong predictors of severe hemorrhagic complications, which, in turn, are associated with reduced survival. The transradial approach represents a simple and effective solution to reduce vascular access site bleedings, particularly with GPIs. Methods: All consecutive patients undergoing urgent transradial PCI under GPI treatment were enrolled in the registry. No patients were excluded. In addition, we performed a case-matched comparison of the transradial versus transfemoral approach using propensity analysis to adjust for known risk factors for bleeding. The primary end point was the rate of bleedings, graded according to the Thrombolysis in Myocardial Infarction (TIMI) classification. Results: Five hundred thirty-one consecutive patients were prospectively enrolled in the registry. TIMI major, minor, and minimal bleedings were 0.2%, 1.7%, and 6.4%, respectively. Transfusion rate was 0.8%. After propensity-matched analysis, the transradial approach was associated with significantly lower rates of all types of bleedings, while the transfemoral approach was the strongest predictor of TIMI major/minor bleedings (odds ratio 6.67; 95% confidence interval 1.72–25; P = 0.006). Conclusions: The transradial approach dramatically reduces access site bleedings, including TIMI major and minor bleedings, and transfusion rate, while preserving procedural success and clinical outcome. The transradial approach is an attractive solution to reduce bleeding complications in patients treated with GPIs. © 2009 Wiley-Liss, Inc. |
| تدمد: | 1522-726X 1522-1946 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fa49ecb6d35de903f9f529bd5cc40436Test https://doi.org/10.1002/ccd.22008Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....fa49ecb6d35de903f9f529bd5cc40436 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1522726X 15221946 |
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