Transradial approach in patients with ST-elevation myocardial infarction treated with abciximab results in fewer bleeding complications: data from EUROTRANSFER registry.

OBJECTIVES

Our aim was to investigate the safety and efficacy of transradial approach, predictors of bleeding complications, and choice of radial access site in a real-life setting using a contemporary European registry of percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI).

BACKGROUND

There is an increasing amount of data suggesting that transradial approach is associated with less bleeding at access site and other vascular complications when compared with procedures carried out through the femoral artery.

METHODS

Consecutive data on STEMI patients transferred for primary PCI in hospital STEMI networks between November 2005 and January 2007 from seven countries in Europe were gathered. Patients were divided into the following two groups: radial approach - with radial access site for primary PCI, and transfemoral approach (FEM) - with femoral access site.

RESULTS

Data from a total of 1650 patients were collected in the EUROTRANSFER Registry. Abciximab was administered in 1086 patients (66%), 169 patients were assigned to radial approach group, whereas 917 to FEM group. Puncture site hematomas were more frequent in the FEM group (1.2 vs. 9.4%, P<0.001). Major bleedings requiring blood transfusion occurred similarly in both the studied groups. Independent predictors of bleeding (puncture site hematoma and major bleeding requiring transfusion) included female sex, lower weight, chronic renal failure, past stroke, and femoral access site (odds ratio=3.54).

CONCLUSION

The choice of radial access site in patients with STEMI treated with primary PCI is associated with lower local bleeding complications like puncture site hematomas and is an independent predictor of fewer bleedings.